Stapling instrument comprising tissue compression systems

ABSTRACT

A surgical stapling instrument comprising an end effector including a jaw closure actuator which is actuated by an initial stroke of a staple firing drive is disclosed.

BACKGROUND

The present invention relates to surgical instruments and, in variousarrangements, to surgical stapling and cutting instruments and staplecartridges for use therewith that are designed to staple and cut tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is an elevational view of a surgical stapling instrument inaccordance with at least one embodiment;

FIG. 2 is an elevational view of a handle of the surgical staplinginstrument of FIG. 1 ;

FIG. 3 is an elevational view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with some componentsremoved;

FIG. 4 is a detail view of a staple firing system of the surgicalstapling instrument of FIG. 3 ;

FIG. 5 is a detail view of the staple firing system of FIG. 4illustrating a first actuation of the staple firing system;

FIG. 6 is a detail view of the staple firing system of FIG. 4illustrating a pawl of the staple firing system being retracted afterthe first actuation;

FIG. 7 is a detail view of the staple firing system of FIG. 4illustrating a second actuation of the staple firing system;

FIG. 8 is a perspective view of an end-of-stroke sensor in accordancewith at least one embodiment;

FIG. 9 is a schematic of a control circuit in accordance with at leastone embodiment;

FIG. 10 is a schematic of a control circuit in accordance with at leastone embodiment;

FIG. 11 is a schematic of a control circuit in accordance with at leastone embodiment;

FIG. 12 illustrates a motor-driven firing drive in accordance with atleast one embodiment;

FIG. 12A is a schematic of a control circuit in accordance with at leastone embodiment;

FIG. 12B illustrates the control circuit of FIG. 12A in a differentswitch state;

FIG. 13 illustrates a solenoid-driven firing drive in accordance with atleast one embodiment;

FIG. 13A is a control circuit of the firing drive of FIG. 13 ;

FIG. 14 is an elevational view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with some componentsremoved;

FIG. 15 is an elevational view of the stapling instrument of FIG. 14illustrating a firing drive in a closed configuration;

FIG. 16 is an elevational view of the stapling instrument of FIG. 14illustrating the firing drive in a staple firing mode;

FIG. 17 is an elevational view of the stapling instrument of FIG. 14illustrating the firing drive being retracted before performing a staplefiring actuation;

FIG. 18 is an elevational view of the stapling instrument of FIG. 14illustrating the firing drive during the staple firing actuation;

FIG. 19 is a graph depicting the operation of a stapling instrumentcomprising a firing drive including a shiftable transmission inaccordance with at least one embodiment;

FIG. 20 is a partial cross-sectional view of a stapling instrumentcomprising a firing drive including a slip clutch in accordance with atleast one embodiment;

FIG. 20A is a cross-sectional view of the slip clutch of FIG. 20 ;

FIG. 21 is a partial perspective view of a stapling instrumentcomprising a bailout drive in accordance with at least one embodiment;

FIG. 22 is a partial elevational view of a stapling instrument inaccordance with at least one embodiment illustrated with some componentsremoved;

FIG. 22A is a schematic of an indicator system of the staplinginstrument of FIG. 22 ;

FIG. 23 is a partial elevational view of a stapling instrumentcomprising a loading unit release actuator in accordance with at leastone embodiment;

FIG. 24 is an elevational view of a stapling instrument comprising adetachable shaft in accordance with at least one embodiment;

FIG. 25 illustrates a proximal end of a detachable shaft in an openconfiguration in accordance with at least one embodiment;

FIG. 25A is a top view of the proximal shaft end of FIG. 25 ;

FIG. 26 is a partial exploded view of a staple cartridge in accordancewith at least one embodiment;

FIG. 26A is a partial perspective view of a firing member in a lockedcondition;

FIG. 26B is a partial exploded view of a staple cartridge in accordancewith at least one embodiment;

FIG. 26C is a partial perspective view of a firing member in a lockedcondition by two sets of lockouts;

FIG. 27 is a partial cross-sectional view of the staple cartridge ofFIG. 26 and the firing member of FIG. 26A in an unlocked condition;

FIG. 28 is a partial cross-sectional view of the staple cartridge ofFIG. 26 and the firing member of FIG. 26A in the locked condition ofFIG. 26A;

FIG. 29 is a partial cross-sectional view of a staple cartridge and afiring member in an unlocked condition in accordance with at least oneembodiment;

FIG. 30 is a partial cross-sectional view of the staple cartridge andfiring member of FIG. 29 illustrating the firing member in a lockedcondition;

FIG. 31 illustrates a spent cartridge/missing cartridge lockout inaccordance with at least one embodiment;

FIG. 31A illustrates a staple cartridge including a sled holding thelockout of FIG. 31 in an unlocked condition;

FIG. 31B illustrates the sled of FIG. 31A being advanced distallythrough a staple firing stroke by a firing member;

FIG. 31C illustrates the firing member of FIG. 31B being retracted afterthe staple firing stroke;

FIG. 31D illustrates the lockout of FIG. 31 in a locked conditionpreventing the firing member from being moved through another firingstroke;

FIG. 32 illustrates a spent cartridge/missing cartridge lockout inaccordance with at least one embodiment;

FIG. 33 illustrates the lockout of FIG. 32 in a locked condition;

FIG. 34 is a partial perspective view of a stapling instrument includinga cartridge lock configured to lock a staple cartridge into a cartridgejaw in accordance with at least one embodiment;

FIG. 35 is a partial cross-sectional view of a staple cartridge seatedin the cartridge jaw of FIG. 34 illustrating the cartridge lock of FIG.34 in an unlocked state;

FIG. 36 is a partial cross-sectional view illustrating the cartridgelock of FIG. 34 in a locked state;

FIG. 37 is a cross-sectional end view of the cartridge jaw of FIG. 34 ;

FIG. 38 is a cross-sectional end view of the staple cartridge of FIG. 35locked in the cartridge jaw of FIG. 34 ;

FIG. 39 is a partial cross-sectional view of a surgical staplinginstrument comprising a firing member that has been moved distally toclose an anvil jaw in accordance with at least one embodiment;

FIG. 40 is a partial cross-sectional view of the stapling instrument ofFIG. 39 illustrating the firing member advanced distally to drive theanvil jaw downwardly;

FIG. 41 is a partial cross-sectional view of the anvil jaw of FIG. 39 inan open position after the firing member has been retracted following astaple firing stroke;

FIG. 42 is a partial cross-sectional view of an end effector of asurgical stapling instrument in accordance with at least one embodimentillustrated in an open configuration;

FIG. 43 is a partial cross-sectional view of the end effector of FIG. 42illustrated in a closed configuration;

FIG. 44 is a partial cross-sectional view of an end effector inaccordance with at least one embodiment;

FIG. 44A is a cross-sectional view of the end effector of FIG. 44 takenalong line 44A-44A in FIG. 44 ;

FIG. 44B is a cross-sectional view of the end effector of FIG. 44 takenalong line 44B-44B in FIG. 44 ;

FIG. 45 is a perspective view of a sled in accordance with at least oneembodiment;

FIG. 45A is an elevational view of the sled of FIG. 45 ;

FIG. 45B is a cross-sectional view of the sled of FIG. 45 ;

FIG. 46 is a partial perspective view of a staple cartridge inaccordance with at least one embodiment;

FIG. 46A is a diagram depicting the staples of the staple cartridge ofFIG. 46 as they are deformed and after they are deformed;

FIG. 46B is a diagram depicting staples as they are deformed and afterthey are deformed in accordance with at least one embodiment;

FIG. 47 is a partial cross-sectional perspective view of an anvil jawand a staple cartridge in accordance with at least one embodimentillustrated with some components removed;

FIG. 48 is a partial cross-sectional view of an anvil jaw and a staplecartridge in accordance with at least one embodiment;

FIG. 49 is a diagram illustrating the staples of the staple cartridge ofFIG. 48 ;

FIG. 50 is a cross-sectional view of an anvil jaw in accordance with atleast one embodiment;

FIG. 51 is a cross-sectional view of an anvil jaw in accordance with atleast one embodiment;

FIG. 52 is a cross-sectional view of an anvil jaw in accordance with atleast one embodiment;

FIG. 52A is a cross-sectional view of the anvil jaw of FIG. 52 after thecomponents of the anvil jaw have been welded;

FIG. 53 is a cross-sectional view of an anvil jaw in accordance with atleast one embodiment;

FIG. 54 is a partial cross-sectional view of a staple cartridge and ananvil in accordance with at least one embodiment;

FIG. 55 is a partial cross-sectional view of an anvil jaw and a staplecartridge in accordance with at least one embodiment;

FIG. 55A is a detail view of the anvil jaw and staple cartridge of FIG.55 ;

FIG. 55B is a detail view of an alternative embodiment to FIG. 55 ;

FIG. 56 is a partial cross-sectional view of an anvil jaw and a staplecartridge in accordance with at least one embodiment;

FIG. 56A is a detail view of the anvil jaw and staple cartridge of FIG.56 ;

FIG. 56B is a detail view of an alternative embodiment to FIG. 56 ;

FIG. 57 is a partial cross-sectional view of a staple cartridge inaccordance with at least one embodiment;

FIG. 58 is a partial elevational view of an end effector including ananvil jaw and a staple cartridge in accordance with at least oneembodiment;

FIG. 59 is a partial perspective view of the anvil jaw of FIG. 58including a detachable adjunct in accordance with at least oneembodiment;

FIG. 60 is a partial perspective view of the staple cartridge of FIG. 58comprising a detachable adjunct seated in a cartridge jaw in accordancewith at least one embodiment;

FIG. 61 is a cross-sectional view of the end effector of FIG. 58 ;

FIG. 61A is cross-sectional view of an end effector in accordance withat least one embodiment;

FIG. 61B is a partial cross-sectional view of a staple cartridge inaccordance with at least one embodiment;

FIG. 62 is an elevational view of a loading unit comprising anarticulation joint in accordance with at least one embodiment;

FIG. 63 is a detail view of the articulation joint of FIG. 62illustrated in an unarticulated condition;

FIG. 64 is a detail view of the articulation joint of FIG. 62illustrated in an articulated condition;

FIG. 65 is a control schematic of a stapling instrument in accordancewith at least one embodiment; and

FIG. 66 is a schematic of a stapling instrument comprising anarticulation joint and an articulation drive including a load limitinginterface.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application also owns the following U.S. patentapplications that were filed on Mar. 22, 2021, and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 17/208,339, entitled METHOD OF        SHIFTING A SURGICAL STAPLING INSTRUMENT, now U.S. Patent        Application Publication No. 2022/0296230;    -   U.S. patent application Ser. No. 17/208,347, entitled STAPLING        INSTRUMENT COMPRISING A PULSED MOTOR-DRIVEN FIRING RACK, now        U.S. Patent Application Publication No. 2022/0296231;    -   U.S. patent application Ser. No. 17/208,357, entitled SURGICAL        STAPLING INSTRUMENT COMPRISING A RETRACTION SYSTEM, now U.S.        Patent Application Publication No. 2022/0296234;    -   U.S. patent application Ser. No. 17/208,362, entitled SURGICAL        INSTRUMENT COMPRISING A FIRING DRIVE INCLUDING A SELECTABLE        LEVERAGE MECHANISM, now U.S. Patent Application Publication No.        2022/0296232;    -   U.S. patent application Ser. No. 17/208,380, entitled STAPLE        CARTRIDGE COMPRISING STAPLES CONFIGURED TO APPLY DIFFERENT        TISSUE COMPRESSION, now U.S. Patent Application Publication No.        2022/0296235;    -   U.S. patent application Ser. No. 17/208,385, entitled STAPLE        CARTRIDGE COMPRISING A FIRING LOCKOUT, now U.S. Patent        Application Publication No. 2022/0296236; and    -   U.S. patent application Ser. No. 17/208,390, entitled STAPLE        CARTRIDGE COMPRISING AN IMPLANTABLE LAYER, now U.S. Patent        Application Publication No. 2022/0296233.

Applicant of the present application also owns the following U.S. PatentApplications that were filed on Feb. 26, 2021 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 17/186,269, entitled METHOD OF        POWERING AND COMMUNICATING WITH A STAPLE CARTRIDGE;    -   U.S. patent application Ser. No. 17/186,273, entitled METHOD OF        POWERING AND COMMUNICATING WITH A STAPLE CARTRIDGE;    -   U.S. patent application Ser. No. 17/186,276, entitled ADJUSTABLE        COMMUNICATION BASED ON AVAILABLE BANDWIDTH AND POWER CAPACITY;    -   U.S. patent application Ser. No. 17/186,283, entitled ADJUSTMENT        TO TRANSFER PARAMETERS TO IMPROVE AVAILABLE POWER;    -   U.S. patent application Ser. No. 17/186,345, entitled MONITORING        OF MANUFACTURING LIFE-CYCLE;    -   U.S. patent application Ser. No. 17/186,350, entitled MONITORING        OF MULTIPLE SENSORS OVER TIME TO DETECT MOVING CHARACTERISTICS        OF TISSUE;    -   U.S. patent application Ser. No. 17/186,353, entitled MONITORING        OF INTERNAL SYSTEMS TO DETECT AND TRACK CARTRIDGE MOTION STATUS;    -   U.S. patent application Ser. No. 17/186,357, entitled DISTAL        COMMUNICATION ARRAY TO TUNE FREQUENCY OF RF SYSTEMS;    -   U.S. patent application Ser. No. 17/186,364, entitled STAPLE        CARTRIDGE COMPRISING A SENSOR ARRAY;    -   U.S. patent application Ser. No. 17/186,373, entitled STAPLE        CARTRIDGE COMPRISING A SENSING ARRAY AND A TEMPERATURE CONTROL        SYSTEM;    -   U.S. patent application Ser. No. 17/186,378, entitled STAPLE        CARTRIDGE COMPRISING AN INFORMATION ACCESS CONTROL SYSTEM;    -   U.S. patent application Ser. No. 17/186,407, entitled STAPLE        CARTRIDGE COMPRISING A POWER MANAGEMENT CIRCUIT;    -   U.S. patent application Ser. No. 17/186,421, entitled STAPLING        INSTRUMENT COMPRISING A SEPARATE POWER ANTENNA AND A DATA        TRANSFER ANTENNA;    -   U.S. patent application Ser. No. 17/186,438, entitled SURGICAL        INSTRUMENT SYSTEM COMPRISING A POWER TRANSFER COIL; and    -   U.S. patent application Ser. No. 17/186,451, entitled STAPLING        INSTRUMENT COMPRISING A SIGNAL. ANTENNA.

Applicant of the present application also owns the following U.S. PatentApplications that were filed on Oct. 29, 2020 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 17/084,179, entitled SURGICAL        INSTRUMENT COMPRISING A RELEASABLE CLOSURE DRIVE LOCK;    -   U.S. patent application Ser. No. 17/084,190, entitled SURGICAL        INSTRUMENT COMPRISING A STOWED CLOSURE ACTUATOR STOP;    -   U.S. patent application Ser. No. 17/084,198, entitled SURGICAL        INSTRUMENT COMPRISING AN INDICATOR WHICH INDICATES THAT AN        ARTICULATION DRIVE IS ACTUATABLE;    -   U.S. patent application Ser. No. 17/084,205, entitled SURGICAL        INSTRUMENT COMPRISING AN ARTICULATION INDICATOR;    -   U.S. patent application Ser. No. 17/084,258, entitled METHOD FOR        OPERATING A SURGICAL INSTRUMENT;    -   U.S. patent application Ser. No. 17/084,206, entitled SURGICAL        INSTRUMENT COMPRISING AN ARTICULATION LOCK;    -   U.S. patent application Ser. No. 17/084,215, entitled SURGICAL        INSTRUMENT COMPRISING A JAW ALIGNMENT SYSTEM;    -   U.S. patent application Ser. No. 17/084,229, entitled SURGICAL        INSTRUMENT COMPRISING SEALABLE INTERFACE;    -   U.S. patent application Ser. No. 17/084,180, entitled SURGICAL        INSTRUMENT COMPRISING A LIMITED TRAVEL SWITCH;    -   U.S. Design Patent Application Serial No. 29/756,615, entitled        SURGICAL STAPLING ASSEMBLY;    -   U.S. Design Patent Application Serial No. 29/756,620, entitled        SURGICAL STAPLING ASSEMBLY;    -   U.S. patent application Ser. No. 17/084,188, entitled SURGICAL        INSTRUMENT COMPRISING A STAGED VOLTAGE REGULATION START-UP        SYSTEM; and    -   U.S. patent application Ser. No. 17/084,193, entitled SURGICAL        INSTRUMENT COMPRISING A SENSOR CONFIGURED TO SENSE WHETHER AN        ARTICULATION DRIVE OF THE SURGICAL INSTRUMENT IS ACTUATABLE.

Applicant of the present application also owns the following U.S. PatentApplications that were filed on Apr. 11, 2020 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/846,303, entitled METHODS        FOR STAPLING TISSUE USING A SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2020/0345353;    -   U.S. patent application Ser. No. 16/846,304, entitled        ARTICULATION ACTUATORS FOR A SURGICAL INSTRUMENT, now U.S.        Patent Application Publication No. 2020/0345354;    -   U.S. patent application Ser. No. 16/846,305, entitled        ARTICULATION DIRECTIONAL LIGHTS ON A SURGICAL INSTRUMENT, now        U.S. Patent Application Publication No. 2020/0345446;    -   U.S. patent application Ser. No. 16/846,307, entitled SHAFT        ROTATION ACTUATOR ON A SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2020/0345349;    -   U.S. patent application Ser. No. 16/846,308, entitled        ARTICULATION CONTROL MAPPING FOR A SURGICAL INSTRUMENT, now U.S.        Patent Application Publication No. 2020/0345355;    -   U.S. patent application Ser. No. 16/846,309, entitled        INTELLIGENT FIRING ASSOCIATED WITH A SURGICAL INSTRUMENT, now        U.S. Patent Application Publication No. 2020/0345356;    -   U.S. patent application Ser. No. 16/846,310, entitled        INTELLIGENT FIRING ASSOCIATED WITH A SURGICAL INSTRUMENT, now        U.S. Patent Application Publication No. 2020/0345357;    -   U.S. patent application Ser. No. 16/846,311, entitled ROTATABLE        JAW TIP FOR A SURGICAL INSTRUMENT, now U.S. Patent Application        Publication No. 2020/0345358;    -   U.S. patent application Ser. No. 16/846,312, entitled TISSUE        STOP FOR A SURGICAL INSTRUMENT, now U.S. Patent Application        Publication No. 2020/0345359; and    -   U.S. patent application Ser. No. 16/846,313, entitled        ARTICULATION PIN FOR A SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2020/0345360.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Jun. 26, 2019 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/453,273, entitled METHOD FOR        PROVIDING AN AUTHENTICATION LOCKOUT IN A SURGICAL STAPLER WITH A        REPLACEABLE CARTRIDGE, now U.S. Patent Application Publication        No. 2020/0261080;

U.S. patent application Ser. No. 16/453,283, entitled SURGICAL STAPLINGASSEMBLY WITH CARTRIDGE BASED RETAINER CONFIGURED TO UNLOCK A FIRINGLOCKOUT, now U.S. Patent Application Publication No. 2020/0261081;

-   -   U.S. patent application Ser. No. 16/453,289, entitled SURGICAL        STAPLING ASSEMBLY WITH CARTRIDGE BASED RETAINER CONFIGURED TO        UNLOCK A CLOSURE LOCKOUT, now U.S. Patent Application        Publication No. 2020/0261082;    -   U.S. patent application Ser. No. 16/453,302, entitled UNIVERSAL        CARTRIDGE BASED KEY FEATURE THAT UNLOCKS MULTIPLE LOCKOUT        ARRANGEMENTS IN DIFFERENT SURGICAL STAPLERS, now U.S. Patent        Application Publication No. 2020/0261075;    -   U.S. patent application Ser. No. 16/453,310, entitled STAPLE        CARTRIDGE RETAINERS WITH FRANGIBLE RETENTION FEATURES AND        METHODS OF USING SAME, now U.S. Patent Application Publication        No. 2020/0261083;    -   U.S. patent application Ser. No. 16/453,330, entitled STAPLE        CARTRIDGE RETAINER WITH FRANGIBLE AUTHENTICATION KEY, now U.S.        Patent Application Publication No. 2020/0261084;    -   U.S. patent application Ser. No. 16/453,335, entitled STAPLE        CARTRIDGE RETAINER WITH RETRACTABLE AUTHENTICATION KEY, now U.S.        Patent Application Publication No. 2020/0261078;    -   U.S. patent application Ser. No. 16/453,343, entitled STAPLE        CARTRIDGE RETAINER SYSTEM WITH AUTHENTICATION KEYS, now U.S.        Patent Application Publication No. 2020/0261085;    -   U.S. patent application Ser. No. 16/453,355, entitled INSERTABLE        DEACTIVATOR ELEMENT FOR SURGICAL STAPLER LOCKOUTS, now U.S.        Patent Application Publication No. 2020/0261086;    -   U.S. patent application Ser. No. 16/453,369, entitled DUAL CAM        CARTRIDGE BASED FEATURE FOR UNLOCKING A SURGICAL STAPLER        LOCKOUT, now U.S. Patent Application Publication No.        2020/0261076;    -   U.S. patent application Ser. No. 16/453,391, entitled STAPLE        CARTRIDGES WITH CAM SURFACES CONFIGURED TO ENGAGE PRIMARY AND        SECONDARY PORTIONS OF A LOCKOUT OF A SURGICAL STAPLING DEVICE,        now U.S. Patent Application Publication No. 2020/0261077;    -   U.S. patent application Ser. No. 16/453,413, entitled SURGICAL        STAPLE CARTRIDGES WITH MOVABLE AUTHENTICATION KEY ARRANGEMENTS,        now U.S. Patent Application Publication No. 2020/0261087;    -   U.S. patent application Ser. No. 16/453,423, entitled        DEACTIVATOR ELEMENT FOR DEFEATING SURGICAL STAPLING DEVICE        LOCKOUTS, now U.S. Patent Application Publication No.        2020/0261088; and    -   U.S. patent application Ser. No. 16/453,429, entitled SURGICAL        STAPLE CARTRIDGES WITH INTEGRAL AUTHENTICATION KEYS, now U.S.        Patent Application Publication No. 2020/0261089.

Applicant of the present application owns the following U.S. DesignPatent Applications that were filed on Jun. 25, 2019, each of which isherein incorporated by reference in its entirety:

-   -   U.S. Design patent application Ser. No. 29/696,066, entitled        SURGICAL STAPLE CARTRIDGE RETAINER WITH FIRING SYSTEM        AUTHENTICATION KEY;    -   U.S. Design patent application Ser. No. 29/696,067, entitled        SURGICAL STAPLE CARTRIDGE RETAINER WITH CLOSURE SYSTEM        AUTHENTICATION KEY; and    -   U.S. Design patent application Ser. No. 29/696,072, entitled        SURGICAL STAPLE CARTRIDGE.

The entire disclosure of U.S. Provisional Patent Application Ser. No.62/866,208, entitled STAPLE CARTRIDGES WITH FEATURES FOR DEFEATINGLOCKOUTS IN SURGICAL STAPLING DEVICES, filed Jun. 25, 2019, is herebyincorporated by reference herein.

The entire disclosure of U.S. Provisional Patent Application Ser. No.62/840,715, entitled SURGICAL INSTRUMENT COMPRISING AN ADAPTIVE CONTROLSYSTEM, filed Apr. 30, 2019, is hereby incorporated by reference herein.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Feb. 21, 2019 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/281,658, entitled METHODS        FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HAS SEPARATE        ROTARY CLOSURE AND FIRING SYSTEMS, now U.S. Patent Application        Publication No. 2019/0298350;    -   U.S. patent application Ser. No. 16/281,670, entitled STAPLE        CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFT A FIRING        MEMBER, now U.S. Patent Application Publication No.        2019/0298340;    -   U.S. patent application Ser. No. 16/281,675, entitled SURGICAL        STAPLERS WITH ARRANGEMENTS FOR MAINTAINING A FIRING MEMBER        THEREOF IN A LOCKED CONFIGURATION UNLESS A COMPATIBLE CARTRIDGE        HAS BEEN INSTALLED THEREIN, now U.S. Patent Application        Publication No. 2019/0298354;    -   U.S. patent application Ser. No. 16/281,685, entitled SURGICAL        INSTRUMENT COMPRISING CO-OPERATING LOCKOUT FEATURES, now U.S.        Patent Application Publication No. 2019/0298341;    -   U.S. patent application Ser. No. 16/281,693, entitled SURGICAL        STAPLING ASSEMBLY COMPRISING A LOCKOUT AND AN EXTERIOR ACCESS        ORIFICE TO PERMIT ARTIFICIAL UNLOCKING OF THE LOCKOUT, now U.S.        Patent Application Publication No. 2019/0298342;    -   U.S. patent application Ser. No. 16/281,704, entitled SURGICAL        STAPLING DEVICES WITH FEATURES FOR BLOCKING ADVANCEMENT OF A        CAMMING ASSEMBLY OF AN INCOMPATIBLE CARTRIDGE INSTALLED THEREIN,        now U.S. Patent Application Publication No. 2019/0298356;    -   U.S. patent application Ser. No. 16/281,707, entitled STAPLING        INSTRUMENT COMPRISING A DEACTIVATABLE LOCKOUT, now U.S. Patent        Application Publication No. 2019/0298347;    -   U.S. patent application Ser. No. 16/281,741, entitled SURGICAL        INSTRUMENT COMPRISING A JAW CLOSURE LOCKOUT, now U.S. Patent        Application Publication No. 2019/0298357;    -   U.S. patent application Ser. No. 16/281,762, entitled SURGICAL        STAPLING DEVICES WITH CARTRIDGE COMPATIBLE CLOSURE AND FIRING        LOCKOUT ARRANGEMENTS, now U.S. Patent Application Publication        No. 2019/0298343;    -   U.S. patent application Ser. No. 16/281,666, entitled SURGICAL        STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURE SYSTEMS,        now U.S. Patent Application Publication No. 2019/0298352;    -   U.S. patent application Ser. No. 16/281,672, entitled SURGICAL        STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES, now U.S.        Patent Application Publication No. 2019/0298353;    -   U.S. patent application Ser. No. 16/281,678, entitled ROTARY        DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND CHANNEL        ENGAGEMENT FEATURES, now U.S. Patent Application Publication No.        2019/0298355; and    -   U.S. patent application Ser. No. 16/281,682, entitled SURGICAL        STAPLING DEVICE WITH SEPARATE ROTARY DRIVEN CLOSURE AND FIRING        SYSTEMS AND FIRING MEMBER THAT ENGAGES BOTH JAWS WHILE FIRING,        now U.S. Patent Application Publication No. 2019/0298346.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications that were filed on Feb. 19, 2019 and which are eachherein incorporated by reference in their respective entireties:

-   -   U.S. Provisional Patent Application Ser. No. 62/807,310,        entitled METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT        HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/807,319,        entitled SURGICAL STAPLING DEVICES WITH IMPROVED LOCKOUT        SYSTEMS; and    -   U.S. Provisional Patent Application Ser. No. 62/807,309,        entitled SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN        CLOSURE SYSTEMS.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Mar. 28, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302,        entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED        COMMUNICATION CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294,        entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS        AND CREATE ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300,        entitled SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309,        entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN        OPERATING THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310,        entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291,        entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO        DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296,        entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND        AUTHENTICATION TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315,        entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS        NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313,        entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320,        entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307,        entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323,        entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS.

Applicant of the present application owns the following U.S. ProvisionalPatent Application, filed on Mar. 30, 2018, which is herein incorporatedby reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/650,887,        entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES.

Applicant of the present application owns the following U.S. PatentApplication, filed on Dec. 4, 2018, which is herein incorporated byreference in its entirety:

-   -   U.S. patent application Ser. No. 16/209,423, entitled METHOD OF        COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY        DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S.        Patent Application Publication No. 2019/0200981.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Aug. 20, 2018 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR        FABRICATING SURGICAL STAPLER ANVILS, now U.S. Patent Application        Publication No. 2020/0054323;    -   U.S. patent application Ser. No. 16/105,183, entitled REINFORCED        DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL, now U.S. Pat.        No. 10,912,559;    -   U.S. patent application Ser. No. 16/105,150, entitled SURGICAL        STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS AND TISSUE        STABILITY FEATURES, now U.S. Patent Application Publication No.        2020/0054326;    -   U.S. patent application Ser. No. 16/105,098, entitled        FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS, now U.S.        Patent Application Publication No. 2020/0054322;    -   U.S. patent application Ser. No. 16/105,140, entitled SURGICAL        STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGURED TO AVOID        TISSUE PINCH, now U.S. Pat. No. 10,779,821;    -   U.S. patent application Ser. No. 16/105,081, entitled METHOD FOR        OPERATING A POWERED ARTICULATABLE SURGICAL INSTRUMENT, now U.S.        Patent Application Publication No. 2020/0054320;    -   U.S. patent application Ser. No. 16/105,094, entitled SURGICAL        INSTRUMENTS WITH PROGRESSIVE JAW CLOSURE ARRANGEMENTS, now U.S.        Patent Application Publication No. 2020/0054321;    -   U.S. patent application Ser. No. 16/105,097, entitled POWERED        SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TO CONVERT        LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS, now U.S. Patent        Application Publication No. 2020/0054328;    -   U.S. patent application Ser. No. 16/105,104, entitled POWERED        ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING AND LOCKING        ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A        FIRING DRIVE SYSTEM, now U.S. Pat. No. 10,842,492;    -   U.S. patent application Ser. No. 16/105,119, entitled        ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITH DEDICATED        ARTICULATION MOTOR ARRANGEMENTS, now U.S. Patent Application        Publication No. 2020/0054330;    -   U.S. patent application Ser. No. 16/105,160, entitled SWITCHING        ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLE SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,856,870; and    -   U.S. Design patent application Ser. No. 29/660,252, entitled        SURGICAL STAPLER ANVILS.

Applicant of the present application owns the following U.S. PatentApplications and U.S. Patents that are each herein incorporated byreference in their respective entireties:

-   -   U.S. patent application Ser. No. 15/386,185, entitled SURGICAL        STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIES THEREOF,        now U.S. Pat. No. 10,639,035;    -   U.S. patent application Ser. No. 15/386,230, entitled        ARTICULATABLE SURGICAL STAPLING INSTRUMENTS, now U.S. Patent        Application Publication No. 2018/0168649;    -   U.S. patent application Ser. No. 15/386,221, entitled LOCKOUT        ARRANGEMENTS FOR SURGICAL END EFFECTORS, now U.S. Pat. No.        10,835,247;    -   U.S. patent application Ser. No. 15/386,209, entitled SURGICAL        END EFFECTORS AND FIRING MEMBERS THEREOF, now U.S. Pat. No.        10,588,632;    -   U.S. patent application Ser. No. 15/386,198, entitled LOCKOUT        ARRANGEMENTS FOR SURGICAL END EFFECTORS AND REPLACEABLE TOOL        ASSEMBLIES, now U.S. Pat. No. 10,610,224;    -   U.S. patent application Ser. No. 15/386,240, entitled SURGICAL        END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR, now U.S.        Patent Application Publication No. 2018/0168651;    -   U.S. patent application Ser. No. 15/385,939, entitled STAPLE        CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES        THEREIN, now U.S. Pat. No. 10,835,246;    -   U.S. patent application Ser. No. 15/385,941, entitled SURGICAL        TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FOR SHIFTING BETWEEN        CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES AND        ARTICULATION AND FIRING SYSTEMS, now U.S. Pat. No. 10,736,629;    -   U.S. patent application Ser. No. 15/385,943, entitled SURGICAL        STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Pat.        No. 10,667,811;    -   U.S. patent application Ser. No. 15/385,950, entitled SURGICAL        TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTION FEATURES, now U.S.        Pat. No. 10,588,630;    -   U.S. patent application Ser. No. 15/385,945, entitled STAPLE        CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES        THEREIN, now U.S. Pat. No. 10,893,864;    -   U.S. patent application Ser. No. 15/385,946, entitled SURGICAL        STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Patent        Application Publication No. 2018/0168633;    -   U.S. patent application Ser. No. 15/385,951, entitled SURGICAL        INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASING A JAW        OPENING DISTANCE, now U.S. Pat. No. 10,568,626;    -   U.S. patent application Ser. No. 15/385,953, entitled METHODS OF        STAPLING TISSUE, now U.S. Pat. No. 10,675,026;    -   U.S. patent application Ser. No. 15/385,954, entitled FIRING        MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FOR SURGICAL        END EFFECTORS, now U.S. Pat. No. 10,624,635;    -   U.S. patent application Ser. No. 15/385,955, entitled SURGICAL        END EFFECTORS WITH EXPANDABLE TISSUE STOP ARRANGEMENTS, now U.S.        Pat. No. 10,813,638;    -   U.S. patent application Ser. No. 15/385,948, entitled SURGICAL        STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Patent        Application Publication No. 2018/0168584;    -   U.S. patent application Ser. No. 15/385,956, entitled SURGICAL        INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES, now U.S. Pat.        No. 10,588,631;    -   U.S. patent application Ser. No. 15/385,958, entitled SURGICAL        INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING        SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT,        now U.S. Pat. No. 10,639,034;    -   U.S. patent application Ser. No. 15/385,947, entitled STAPLE        CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES        THEREIN, now U.S. Pat. No. 10,568,625;    -   U.S. patent application Ser. No. 15/385,896, entitled METHOD FOR        RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT, now U.S. Patent        Application Publication No. 2018/0168597;    -   U.S. patent application Ser. No. 15/385,898, entitled        STAPLE-FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENT TYPES        OF STAPLES, now U.S. Pat. No. 10,537,325;    -   U.S. patent application Ser. No. 15/385,899, entitled SURGICAL        INSTRUMENT COMPRISING IMPROVED JAW CONTROL, now U.S. Pat. No.        10,758,229;    -   U.S. patent application Ser. No. 15/385,901, entitled STAPLE        CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISING WINDOWS        DEFINED THEREIN, now U.S. Pat. No. 10,667,809;    -   U.S. patent application Ser. No. 15/385,902, entitled SURGICAL        INSTRUMENT COMPRISING A CUTTING MEMBER, now U.S. Pat. No.        10,888,322;    -   U.S. patent application Ser. No. 15/385,904, entitled STAPLE        FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/OR SPENT        CARTRIDGE LOCKOUT, now U.S. Pat. No. 10,881,401;    -   U.S. patent application Ser. No. 15/385,905, entitled FIRING        ASSEMBLY COMPRISING A LOCKOUT, now U.S. Pat. No. 10,695,055;    -   U.S. patent application Ser. No. 15/385,907, entitled SURGICAL        INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUT AND A        FIRING ASSEMBLY LOCKOUT, now U.S. Patent Application Publication        No. 2018/0168608;    -   U.S. patent application Ser. No. 15/385,908, entitled FIRING        ASSEMBLY COMPRISING A FUSE, now U.S. Patent Application        Publication No. 2018/0168609;    -   U.S. patent application Ser. No. 15/385,909, entitled FIRING        ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE, now U.S.        Patent Application Publication No. 2018/0168610;    -   U.S. patent application Ser. No. 15/385,920, entitled        STAPLE-FORMING POCKET ARRANGEMENTS, now U.S. Pat. No.        10,499,914;    -   U.S. patent application Ser. No. 15/385,913, entitled ANVIL        ARRANGEMENTS FOR SURGICAL STAPLERS, now U.S. Patent Application        Publication No. 2018/0168614;    -   U.S. patent application Ser. No. 15/385,914, entitled METHOD OF        DEFORMING STAPLES FROM TWO DIFFERENT TYPES OF STAPLE CARTRIDGES        WITH THE SAME SURGICAL STAPLING INSTRUMENT, now U.S. Patent        Application Publication No. 2018/0168615;    -   U.S. patent application Ser. No. 15/385,893, entitled        BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS, now U.S.        Pat. No. 10,682,138;    -   U.S. patent application Ser. No. 15/385,929, entitled CLOSURE        MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICAL INSTRUMENTS        WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS, now U.S.        Pat. No. 10,667,810;    -   U.S. patent application Ser. No. 15/385,911, entitled SURGICAL        STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING AND FIRING        SYSTEMS, now U.S. Pat. No. 10,448,950;    -   U.S. patent application Ser. No. 15/385,927, entitled SURGICAL        STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES, now U.S.        Patent Application Publication No. 2018/0168625;    -   U.S. patent application Ser. No. 15/385,917, entitled STAPLE        CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPING BREADTHS,        now U.S. Patent Application Publication No. 2018/0168617;    -   U.S. patent application Ser. No. 15/385,900, entitled        STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING PRIMARY SIDEWALLS        AND POCKET SIDEWALLS, now U.S. Pat. No. 10,898,186;    -   U.S. patent application Ser. No. 15/385,931, entitled        NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FOR        SURGICAL STAPLERS, now U.S. Patent Application Publication No.        2018/0168627;    -   U.S. patent application Ser. No. 15/385,915, entitled FIRING        MEMBER PIN ANGLE, now U.S. Pat. No. 10,779,823;    -   U.S. patent application Ser. No. 15/385,897, entitled        STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMING        SURFACE GROOVES, now U.S. Patent Application Publication No.        2018/0168598;    -   U.S. patent application Ser. No. 15/385,922, entitled SURGICAL        INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES, now U.S. Pat.        No. 10,426,471;    -   U.S. patent application Ser. No. 15/385,924, entitled SURGICAL        INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS, now U.S. Pat. No.        10,758,230;    -   U.S. patent application Ser. No. 15/385,910, entitled ANVIL        HAVING A KNIFE SLOT WIDTH, now U.S. Pat. No. 10,485,543;    -   U.S. patent application Ser. No. 15/385,903, entitled CLOSURE        MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No.        10,617,414;    -   U.S. patent application Ser. No. 15/385,906, entitled FIRING        MEMBER PIN CONFIGURATIONS, now U.S. Pat. No. 10,856,868;    -   U.S. patent application Ser. No. 15/386,188, entitled STEPPED        STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES, now U.S. Pat. No.        10,537,324;    -   U.S. patent application Ser. No. 15/386,192, entitled STEPPED        STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAP SETTING FEATURES,        now U.S. Pat. No. 10,687,810;    -   U.S. patent application Ser. No. 15/386,206, entitled STAPLE        CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES, now U.S.        Patent Application Publication No. 2018/0168586;    -   U.S. patent application Ser. No. 15/386,226, entitled DURABILITY        FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIES OF SURGICAL        STAPLING INSTRUMENTS, now U.S. Patent Application Publication        No. 2018/0168648;    -   U.S. patent application Ser. No. 15/386,222, entitled SURGICAL        STAPLING INSTRUMENTS HAVING END EFFECTORS WITH POSITIVE OPENING        FEATURES, now U.S. Patent Application Publication No.        2018/0168647;    -   U.S. patent application Ser. No. 15/386,236, entitled CONNECTION        PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICAL STAPLING        INSTRUMENTS, now U.S. Patent Application Publication No.        2018/0168650;    -   U.S. patent application Ser. No. 15/385,887, entitled METHOD FOR        ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND,        ALTERNATIVELY, TO A SURGICAL ROBOT, now U.S. Pat. No.        10,835,245;    -   U.S. patent application Ser. No. 15/385,889, entitled SHAFT        ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTION SYSTEM FOR        USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM, now U.S. Patent        Application Publication No. 2018/0168590;    -   U.S. patent application Ser. No. 15/385,890, entitled SHAFT        ASSEMBLY COMPRISING SEPARATELY ACTUATABLE AND RETRACTABLE        SYSTEMS, now U.S. Pat. No. 10,675,025;    -   U.S. patent application Ser. No. 15/385,891, entitled SHAFT        ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THE OUTPUT OF A        ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS, now U.S. Patent        Application Publication No. 2018/0168592;    -   U.S. patent application Ser. No. 15/385,892, entitled SURGICAL        SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO AN ARTICULATION        STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM, now        U.S. Pat. No. 10,918,385;    -   U.S. patent application Ser. No. 15/385,894, entitled SHAFT        ASSEMBLY COMPRISING A LOCKOUT, now U.S. Pat. No. 10,492,785;    -   U.S. patent application Ser. No. 15/385,895, entitled SHAFT        ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATION LOCKOUTS, now        U.S. Pat. No. 10,542,982;    -   U.S. patent application Ser. No. 15/385,916, entitled SURGICAL        STAPLING SYSTEMS, now U.S. Patent Application Publication No.        2018/0168575;    -   U.S. patent application Ser. No. 15/385,918, entitled SURGICAL        STAPLING SYSTEMS, now U.S. Patent Application Publication No.        2018/0168618;    -   U.S. patent application Ser. No. 15/385,919, entitled SURGICAL        STAPLING SYSTEMS, now U.S. Patent Application Publication No.        2018/0168619;    -   U.S. patent application Ser. No. 15/385,921, entitled SURGICAL        STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBER CONFIGURED TO        DISENGAGE FIRING MEMBER LOCKOUT FEATURES, now U.S. Pat. No.        10,687,809;    -   U.S. patent application Ser. No. 15/385,923, entitled SURGICAL        STAPLING SYSTEMS, now U.S. Patent Application Publication No.        2018/0168623;    -   U.S. patent application Ser. No. 15/385,925, entitled JAW        ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OF A        FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED        CARTRIDGE IS INSTALLED IN THE END EFFECTOR, now U.S. Pat. No.        10,517,595;    -   U.S. patent application Ser. No. 15/385,926, entitled AXIALLY        MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYING CLOSURE MOTIONS        TO JAWS OF SURGICAL INSTRUMENTS, now U.S. Patent Application        Publication No. 2018/0168577;    -   U.S. patent application Ser. No. 15/385,928, entitled PROTECTIVE        COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN A MOVABLE JAW        AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT, now U.S. Patent        Application Publication No. 2018/0168578;    -   U.S. patent application Ser. No. 15/385,930, entitled SURGICAL        END EFFECTOR WITH TWO SEPARATE COOPERATING OPENING FEATURES FOR        OPENING AND CLOSING END EFFECTOR JAWS, now U.S. Patent        Application Publication No. 2018/0168579;    -   U.S. patent application Ser. No. 15/385,932, entitled        ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFT        ARRANGEMENT, now U.S. Patent Application Publication No.        2018/0168628;    -   U.S. patent application Ser. No. 15/385,933, entitled        ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLE        LINKAGE DISTAL OF AN ARTICULATION LOCK, now U.S. Pat. No.        10,603,036;    -   U.S. patent application Ser. No. 15/385,934, entitled        ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR IN AN        ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE        SYSTEM, now U.S. Pat. No. 10,582,928;    -   U.S. patent application Ser. No. 15/385,935, entitled LATERALLY        ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END        EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATED        CONFIGURATION, now U.S. Pat. No. 10,524,789;    -   U.S. patent application Ser. No. 15/385,936, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKE        AMPLIFICATION FEATURES, now U.S. Pat. No. 10,517,596;    -   U.S. patent application Ser. No. 14/318,996, entitled FASTENER        CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS,        now U.S. Patent Application Publication No. 2015/0297228;    -   U.S. patent application Ser. No. 14/319,006, entitled FASTENER        CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER        CONTROL FEATURES, now U.S. Pat. No. 10,010,324;    -   U.S. patent application Ser. No. 14/318,991, entitled SURGICAL        FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS, now        U.S. Pat. No. 9,833,241;    -   U.S. patent application Ser. No. 14/319,004, entitled SURGICAL        END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS, now        U.S. Pat. No. 9,844,369;    -   U.S. patent application Ser. No. 14/319,008, entitled FASTENER        CARTRIDGE COMPRISING NON-UNIFORM FASTENERS, now U.S. Pat. No.        10,299,792;    -   U.S. patent application Ser. No. 14/318,997, entitled FASTENER        CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS, now        U.S. Pat. No. 10,561,422;    -   U.S. patent application Ser. No. 14/319,002, entitled FASTENER        CARTRIDGE COMPRISING TISSUE CONTROL FEATURES, now U.S. Pat. No.        9,877,721;    -   U.S. patent application Ser. No. 14/319,013, entitled FASTENER        CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS, now        U.S. Patent Application Publication No. 2015/0297233; and    -   U.S. patent application Ser. No. 14/319,016, entitled FASTENER        CARTRIDGE INCLUDING A LAYER ATTACHED THERETO, now U.S. Pat. No.        10,470,768.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Jun. 24, 2016 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 15/191,775, entitled STAPLE        CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES, now U.S.        Patent Application Publication No. 2017/0367695;    -   U.S. patent application Ser. No. 15/191,807, entitled STAPLING        SYSTEM FOR USE WITH WIRE STAPLES AND STAMPED STAPLES, now U.S.        Pat. No. 10,702,270;    -   U.S. patent application Ser. No. 15/191,834, entitled STAMPED        STAPLES AND STAPLE CARTRIDGES USING THE SAME, now U.S. Pat. No.        10,542,979;    -   U.S. patent application Ser. No. 15/191,788, entitled STAPLE        CARTRIDGE COMPRISING OVERDRIVEN STAPLES, now U.S. Pat. No.        10,675,024; and    -   U.S. patent application Ser. No. 15/191,818, entitled STAPLE        CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS, now U.S.        Pat. No. 10,893,863.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Jun. 24, 2016 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Design patent application Ser. No. 29/569,218, entitled        SURGICAL FASTENER, now U.S. Design Pat. No. D826,405;    -   U.S. Design patent application Ser. No. 29/569,227, entitled        SURGICAL FASTENER, now U.S. Design Pat. No. D822,206;    -   U.S. Design patent application Ser. No. 29/569,259, entitled        SURGICAL FASTENER CARTRIDGE, now U.S. Design Pat. No. D847,989;        and    -   U.S. Design patent application Ser. No. 29/569,264, entitled        SURGICAL FASTENER CARTRIDGE, now U.S. Design Pat. No. D850,617.

Applicant of the present application owns the following patentapplications that were filed on Apr. 1, 2016 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 15/089,325, entitled METHOD FOR        OPERATING A SURGICAL STAPLING SYSTEM, now U.S. Patent        Application Publication No. 2017/0281171;    -   U.S. patent application Ser. No. 15/089,321, entitled MODULAR        SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY, now U.S. Pat. No.        10,271,851;    -   U.S. patent application Ser. No. 15/089,326, entitled SURGICAL        STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE        DISPLAY FIELD, now U.S. Pat. No. 10,433,849;    -   U.S. patent application Ser. No. 15/089,263, entitled SURGICAL        INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION, now        U.S. Pat. No. 10,307,159;    -   U.S. patent application Ser. No. 15/089,262, entitled ROTARY        POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE BAILOUT        SYSTEM, now U.S. Pat. No. 10,357,246;    -   U.S. patent application Ser. No. 15/089,277, entitled SURGICAL        CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE        MEMBER, now U.S. Pat. No. 10,531,874;    -   U.S. patent application Ser. No. 15/089,296, entitled        INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END        EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS, now        U.S. Pat. No. 10,413,293;    -   U.S. patent application Ser. No. 15/089,258, entitled SURGICAL        STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION, now U.S.        Pat. No. 10,342,543;    -   U.S. patent application Ser. No. 15/089,278, entitled SURGICAL        STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF        TISSUE, now U.S. Pat. No. 10,420,552;    -   U.S. patent application Ser. No. 15/089,284, entitled SURGICAL        STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT, now U.S. Patent        Application Publication No. 2017/0281186;    -   U.S. patent application Ser. No. 15/089,295, entitled SURGICAL        STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT, now        U.S. Pat. No. 10,856,867;    -   U.S. patent application Ser. No. 15/089,300, entitled SURGICAL        STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT, now U.S. Pat.        No. 10,456,140;    -   U.S. patent application Ser. No. 15/089,196, entitled SURGICAL        STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT, now U.S. Pat.        No. 10,568,632;    -   U.S. patent application Ser. No. 15/089,203, entitled SURGICAL        STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT, now U.S.        Pat. No. 10,542,991;    -   U.S. patent application Ser. No. 15/089,210, entitled SURGICAL        STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT, now U.S.        Pat. No. 10,478,190;    -   U.S. patent application Ser. No. 15/089,324, entitled SURGICAL        INSTRUMENT COMPRISING A SHIFTING MECHANISM, now U.S. Pat. No.        10,314,582;    -   U.S. patent application Ser. No. 15/089,335, entitled SURGICAL        STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS, now U.S. Pat.        No. 10,485,542;    -   U.S. patent application Ser. No. 15/089,339, entitled SURGICAL        STAPLING INSTRUMENT, now U.S. Patent Application Publication No.        2017/0281173;    -   U.S. patent application Ser. No. 15/089,253, entitled SURGICAL        STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES        HAVING DIFFERENT HEIGHTS, now U.S. Pat. No. 10,413,297;    -   U.S. patent application Ser. No. 15/089,304, entitled SURGICAL        STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET, now U.S.        Pat. No. 10,285,705;    -   U.S. patent application Ser. No. 15/089,331, entitled ANVIL        MODIFICATION MEMBERS FOR SURGICAL STAPLERS, now U.S. Pat. No.        10,376,263;    -   U.S. patent application Ser. No. 15/089,336, entitled STAPLE        CARTRIDGES WITH ATRAUMATIC FEATURES, now U.S. Pat. No.        10,709,446;    -   U.S. patent application Ser. No. 15/089,312, entitled CIRCULAR        STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT, now U.S.        Patent Application Publication No. 2017/0281189;    -   U.S. patent application Ser. No. 15/089,309, entitled CIRCULAR        STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM, now U.S. Pat.        No. 10,675,021; and    -   U.S. patent application Ser. No. 15/089,349, entitled CIRCULAR        STAPLING SYSTEM COMPRISING LOAD CONTROL, now U.S. Pat. No.        10,682,136.

Applicant of the present application also owns the U.S. PatentApplications identified below which were filed on Dec. 30, 2015 whichare each herein incorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/984,488, entitled MECHANISMS        FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,292,704;    -   U.S. patent application Ser. No. 14/984,525, entitled MECHANISMS        FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,368,865; and    -   U.S. patent application Ser. No. 14/984,552, entitled SURGICAL        INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROL CIRCUITS,        now U.S. Pat. No. 10,265,068.

Applicant of the present application also owns the U.S. PatentApplications identified below which were filed on Feb. 9, 2016, whichare each herein incorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 15/019,220, entitled SURGICAL        INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END        EFFECTOR, now U.S. Pat. No. 10,245,029;    -   U.S. patent application Ser. No. 15/019,228, entitled SURGICAL        INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS, now        U.S. Pat. No. 10,433,837;    -   U.S. patent application Ser. No. 15/019,196, entitled SURGICAL        INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY        CONSTRAINT, now U.S. Pat. No. 10,413,291;    -   U.S. patent application Ser. No. 15/019,206, entitled SURGICAL        INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY ARTICULATABLE        RELATIVE TO AN ELONGATE SHAFT ASSEMBLY, now U.S. Pat. No.        10,653,413;    -   U.S. patent application Ser. No. 15/019,215, entitled SURGICAL        INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION ARRANGEMENTS, now        U.S. Patent Application Publication No. 2017/0224332;    -   U.S. patent application Ser. No. 15/019,227, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK        ARRANGEMENTS, now U.S. Patent Application Publication No.        2017/0224334;    -   U.S. patent application Ser. No. 15/019,235, entitled SURGICAL        INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN        ARTICULATION SYSTEMS, now U.S. Pat. No. 10,245,030;    -   U.S. patent application Ser. No. 15/019,230, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM        ARRANGEMENTS, now U.S. Pat. No. 10,588,625; and    -   U.S. patent application Ser. No. 15/019,245, entitled SURGICAL        INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS, now U.S.        Pat. No. 10,470,764.

Applicant of the present application also owns the U.S. PatentApplications identified below which were filed on Feb. 12, 2016, whichare each herein incorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 15/043,254, entitled MECHANISMS        FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,258,331;    -   U.S. patent application Ser. No. 15/043,259, entitled MECHANISMS        FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,448,948;    -   U.S. patent application Ser. No. 15/043,275, entitled MECHANISMS        FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Patent Application Publication No.        2017/0231627; and    -   U.S. patent application Ser. No. 15/043,289, entitled MECHANISMS        FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL        INSTRUMENTS, now U.S. Patent Application Publication No.        2017/0231628.

Applicant of the present application owns the following patentapplications that were filed on Jun. 18, 2015 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/742,925, entitled SURGICAL        END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS, now U.S.        Pat. No. 10,182,818;    -   U.S. patent application Ser. No. 14/742,941, entitled SURGICAL        END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES, now        U.S. Pat. No. 10,052,102;    -   U.S. patent application Ser. No. 14/742,933, entitled SURGICAL        STAPLING INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING        FIRING SYSTEM ACTUATION WHEN A CARTRIDGE IS SPENT OR MISSING,        now U.S. Pat. No. 10,154,841;    -   U.S. patent application Ser. No. 14/742,914, entitled MOVABLE        FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,405,863;    -   U.S. patent application Ser. No. 14/742,900, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM        STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION        SUPPORT, now U.S. Pat. No. 10,335,149;    -   U.S. patent application Ser. No. 14/742,885, entitled DUAL        ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE        SURGICAL INSTRUMENTS, now U.S. Pat. No. 10,368,861; and    -   U.S. patent application Ser. No. 14/742,876, entitled PUSH/PULL        ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,178,992.

Applicant of the present application owns the following patentapplications that were filed on Mar. 6, 2015 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/640,746, entitled POWERED        SURGICAL INSTRUMENT, now U.S. Pat. No. 9,808,246;    -   U.S. patent application Ser. No. 14/640,795, entitled MULTIPLE        LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL        INSTRUMENTS, now U.S. Pat. No. 10,441,279;    -   U.S. patent application Ser. No. 14/640,832, entitled ADAPTIVE        TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR        MULTIPLE TISSUE TYPES, now U.S. Pat. No. 10,687,806;    -   U.S. patent application Ser. No. 14/640,935, entitled OVERLAID        MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE        TISSUE COMPRESSION, now U.S. Pat. No. 10,548,504;    -   U.S. patent application Ser. No. 14/640,831, entitled MONITORING        SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED        SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,895,148;    -   U.S. patent application Ser. No. 14/640,859, entitled TIME        DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY,        CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES, now U.S. Pat. No.        10,052,044;    -   U.S. patent application Ser. No. 14/640,817, entitled        INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS,        now U.S. Pat. No. 9,924,961;    -   U.S. patent application Ser. No. 14/640,844, entitled CONTROL        TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH        SELECT CONTROL PROCESSING FROM HANDLE, now U.S. Pat. No.        10,045,776;    -   U.S. patent application Ser. No. 14/640,837, entitled SMART        SENSORS WITH LOCAL SIGNAL PROCESSING, now U.S. Pat. No.        9,993,248;    -   U.S. patent application Ser. No. 14/640,765, entitled SYSTEM FOR        DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A        SURGICAL STAPLER, now U.S. Pat. No. 10,617,412;    -   U.S. patent application Ser. No. 14/640,799, entitled SIGNAL AND        POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT, now        U.S. Pat. No. 9,901,342; and    -   U.S. patent application Ser. No. 14/640,780, entitled SURGICAL        INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING, now U.S. Pat.        No. 10,245,033.

Applicant of the present application owns the following patentapplications that were filed on Feb. 27, 2015, and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/633,576, entitled SURGICAL        INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION, now U.S.        Pat. No. 10,045,779;    -   U.S. patent application Ser. No. 14/633,546, entitled SURGICAL        APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER        OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE        BAND, now U.S. Pat. No. 10,180,463;    -   U.S. patent application Ser. No. 14/633,560, entitled SURGICAL        CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE OR MORE        BATTERIES, now U.S. Patent Application Publication No.        2016/0249910;    -   U.S. patent application Ser. No. 14/633,566, entitled CHARGING        SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A        BATTERY, now U.S. Pat. No. 10,182,816;    -   U.S. patent application Ser. No. 14/633,555, entitled SYSTEM FOR        MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED,        now U.S. Pat. No. 10,321,907;    -   U.S. patent application Ser. No. 14/633,542, entitled REINFORCED        BATTERY FOR A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,931,118;    -   U.S. patent application Ser. No. 14/633,548, entitled POWER        ADAPTER FOR A SURGICAL INSTRUMENT, now U.S. Pat. No. 10,245,028;    -   U.S. patent application Ser. No. 14/633,526, entitled ADAPTABLE        SURGICAL INSTRUMENT HANDLE, now U.S. Pat. No. 9,993,258;    -   U.S. patent application Ser. No. 14/633,541, entitled MODULAR        STAPLING ASSEMBLY, now U.S. Pat. No. 10,226,250; and    -   U.S. patent application Ser. No. 14/633,562, entitled SURGICAL        APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER, now U.S.        Pat. No. 10,159,483.

Applicant of the present application owns the following patentapplications that were filed on Dec. 18, 2014 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/574,478, entitled SURGICAL        INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND        MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER, now        U.S. Pat. No. 9,844,374;    -   U.S. patent application Ser. No. 14/574,483, entitled SURGICAL        INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS, now U.S. Pat.        No. 10,188,385;    -   U.S. patent application Ser. No. 14/575,139, entitled DRIVE        ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S.        Pat. No. 9,844,375;    -   U.S. patent application Ser. No. 14/575,148, entitled LOCKING        ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE        SURGICAL END EFFECTORS, now U.S. Pat. No. 10,085,748;    -   U.S. patent application Ser. No. 14/575,130, entitled SURGICAL        INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A        DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE, now        U.S. Pat. No. 10,245,027;    -   U.S. patent application Ser. No. 14/575,143, entitled SURGICAL        INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS, now U.S. Pat.        No. 10,004,501;    -   U.S. patent application Ser. No. 14/575,117, entitled SURGICAL        INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING        BEAM SUPPORT ARRANGEMENTS, now U.S. Pat. No. 9,943,309;    -   U.S. patent application Ser. No. 14/575,154, entitled SURGICAL        INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING        BEAM SUPPORT ARRANGEMENTS, now U.S. Pat. No. 9,968,355;    -   U.S. patent application Ser. No. 14/574,493, entitled SURGICAL        INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM,        now U.S. Pat. No. 9,987,000; and    -   U.S. patent application Ser. No. 14/574,500, entitled SURGICAL        INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM,        now U.S. Pat. No. 10,117,649.

Applicant of the present application owns the following patentapplications that were filed on Mar. 1, 2013 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 13/782,295, entitled        ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR        SIGNAL COMMUNICATION, now U.S. Pat. No. 9,700,309;    -   U.S. patent application Ser. No. 13/782,323, entitled ROTARY        POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS, now U.S.        Pat. No. 9,782,169;    -   U.S. patent application Ser. No. 13/782,338, entitled THUMBWHEEL        SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent        Application Publication No. 2014/0249557;    -   U.S. patent application Ser. No. 13/782,499, entitled        ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT,        now U.S. Pat. No. 9,358,003;    -   U.S. patent application Ser. No. 13/782,460, entitled MULTIPLE        PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS, now        U.S. Pat. No. 9,554,794;    -   U.S. patent application Ser. No. 13/782,358, entitled JOYSTICK        SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS, now U.S. Pat. No.        9,326,767;    -   U.S. patent application Ser. No. 13/782,481, entitled SENSOR        STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR, now        U.S. Pat. No. 9,468,438;    -   U.S. patent application Ser. No. 13/782,518, entitled CONTROL        METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT        PORTIONS, now U.S. Patent Application Publication No.        2014/0246475;    -   U.S. patent application Ser. No. 13/782,375, entitled ROTARY        POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM,        now U.S. Pat. No. 9,398,911; and    -   U.S. patent application Ser. No. 13/782,536, entitled SURGICAL        INSTRUMENT SOFT STOP, now U.S. Pat. No. 9,307,986.

Applicant of the present application also owns the following patentapplications that were filed on Mar. 14, 2013 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 13/803,097, entitled        ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, now        U.S. Pat. No. 9,687,230;    -   U.S. patent application Ser. No. 13/803,193, entitled CONTROL        ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, now        U.S. Pat. No. 9,332,987;    -   U.S. patent application Ser. No. 13/803,053, entitled        INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL        INSTRUMENT, now U.S. Pat. No. 9,883,860;    -   U.S. patent application Ser. No. 13/803,086, entitled        ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION        LOCK, now U.S. Patent Application Publication No. 2014/0263541;    -   U.S. patent application Ser. No. 13/803,210, entitled SENSOR        ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL        INSTRUMENTS, now U.S. Pat. No. 9,808,244;    -   U.S. patent application Ser. No. 13/803,148, entitled        MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, now U.S. Pat.        No. 10,470,762;    -   U.S. patent application Ser. No. 13/803,066, entitled DRIVE        SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS,        now U.S. Pat. No. 9,629,623;    -   U.S. patent application Ser. No. 13/803,117, entitled        ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL        INSTRUMENTS, now U.S. Pat. No. 9,351,726;    -   U.S. patent application Ser. No. 13/803,130, entitled DRIVE        TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now        U.S. Pat. No. 9,351,727; and    -   U.S. patent application Ser. No. 13/803,159, entitled METHOD AND        SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, now U.S. Pat. No.        9,888,919.

Applicant of the present application also owns the following patentapplication that was filed on Mar. 7, 2014 and is herein incorporated byreference in its entirety:

-   -   U.S. patent application Ser. No. 14/200,111, entitled CONTROL        SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629.

Applicant of the present application also owns the following patentapplications that were filed on Mar. 26, 2014 and are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/226,106, entitled POWER        MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S.        Patent Application Publication No. 2015/0272582;    -   U.S. patent application Ser. No. 14/226,099, entitled        STERILIZATION VERIFICATION CIRCUIT, now U.S. Pat. No. 9,826,977;    -   U.S. patent application Ser. No. 14/226,094, entitled        VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT, now        U.S. Patent Application Publication No. 2015/0272580;    -   U.S. patent application Ser. No. 14/226,117, entitled POWER        MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE        UP CONTROL, now U.S. Pat. No. 10,013,049;    -   U.S. patent application Ser. No. 14/226,075, entitled MODULAR        POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES,        now U.S. Pat. No. 9,743,929;    -   U.S. patent application Ser. No. 14/226,093, entitled FEEDBACK        ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS,        now U.S. Pat. No. 10,028,761;    -   U.S. patent application Ser. No. 14/226,116, entitled SURGICAL        INSTRUMENT UTILIZING SENSOR ADAPTATION, now U.S. Patent        Application Publication No. 2015/0272571;    -   U.S. patent application Ser. No. 14/226,071, entitled SURGICAL        INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR, now U.S.        Pat. No. 9,690,362;    -   U.S. patent application Ser. No. 14/226,097, entitled SURGICAL        INSTRUMENT COMPRISING INTERACTIVE SYSTEMS, now U.S. Pat. No.        9,820,738;    -   U.S. patent application Ser. No. 14/226,126, entitled INTERFACE        SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS, now U.S. Pat. No.        10,004,497;    -   U.S. patent application Ser. No. 14/226,133, entitled MODULAR        SURGICAL INSTRUMENT SYSTEM, now U.S. Patent Application        Publication No. 2015/0272557;    -   U.S. patent application Ser. No. 14/226,081, entitled SYSTEMS        AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT, now U.S. Pat.        No. 9,804,618;    -   U.S. patent application Ser. No. 14/226,076, entitled POWER        MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE        PROTECTION, now U.S. Pat. No. 9,733,663;    -   U.S. patent application Ser. No. 14/226,111, entitled SURGICAL        STAPLING INSTRUMENT SYSTEM, now U.S. Pat. No. 9,750,499; and    -   U.S. patent application Ser. No. 14/226,125, entitled SURGICAL        INSTRUMENT COMPRISING A ROTATABLE SHAFT, now U.S. Pat. No.        10,201,364.

Applicant of the present application also owns the following patentapplications that were filed on Sep. 5, 2014 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/479,103, entitled CIRCUITRY        AND SENSORS FOR POWERED MEDICAL DEVICE, now U.S. Pat. No.        10,111,679;    -   U.S. patent application Ser. No. 14/479,119, entitled ADJUNCT        WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION, now U.S.        Pat. No. 9,724,094;    -   U.S. patent application Ser. No. 14/478,908, entitled MONITORING        DEVICE DEGRADATION BASED ON COMPONENT EVALUATION, now U.S. Pat.        No. 9,737,301;    -   U.S. patent application Ser. No. 14/478,895, entitled MULTIPLE        SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR        INTERPRETATION, now U.S. Pat. No. 9,757,128;    -   U.S. patent application Ser. No. 14/479,110, entitled POLARITY        OF HALL MAGNET TO IDENTIFY CARTRIDGE TYPE, now U.S. Pat. No.        10,016,199;    -   U.S. patent application Ser. No. 14/479,098, entitled SMART        CARTRIDGE WAKE UP OPERATION AND DATA RETENTION, now U.S. Pat.        No. 10,135,242;    -   U.S. patent application Ser. No. 14/479,115, entitled MULTIPLE        MOTOR CONTROL FOR POWERED MEDICAL DEVICE, now U.S. Pat. No.        9,788,836; and    -   U.S. patent application Ser. No. 14/479,108, entitled LOCAL        DISPLAY OF TISSUE PARAMETER STABILIZATION, now U.S. Patent        Application Publication No. 2016/0066913.

Applicant of the present application also owns the following patentapplications that were filed on Apr. 9, 2014 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. patent application Ser. No. 14/248,590, entitled MOTOR        DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now        U.S. Pat. No. 9,826,976;    -   U.S. patent application Ser. No. 14/248,581, entitled SURGICAL        INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE        OPERATED FROM THE SAME ROTATABLE OUTPUT, now U.S. Pat. No.        9,649,110;    -   U.S. patent application Ser. No. 14/248,595, entitled SURGICAL        SYSTEM COMPRISING FIRST AND SECOND DRIVE SYSTEMS, now U.S. Pat.        No. 9,844,368;    -   U.S. patent application Ser. No. 14/248,588, entitled POWERED        LINEAR SURGICAL STAPLER, now U.S. Pat. No. 10,405,857;    -   U.S. patent application Ser. No. 14/248,591, entitled SURGICAL        INSTRUMENT COMPRISING A GAP SETTING SYSTEM, now U.S. Pat. No.        10,149,680;    -   U.S. patent application Ser. No. 14/248,584, entitled MODULAR        MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR        ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS,        now U.S. Pat. No. 9,801,626;    -   U.S. patent application Ser. No. 14/248,587, entitled POWERED        SURGICAL STAPLER, now U.S. Pat. No. 9,867,612;    -   U.S. patent application Ser. No. 14/248,586, entitled DRIVE        SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, now        U.S. Pat. No. 10,136,887; and    -   U.S. patent application Ser. No. 14/248,607, entitled MODULAR        MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION        ARRANGEMENTS, now U.S. Pat. No. 9,814,460.

Applicant of the present application also owns the following patentapplications that were filed on Apr. 16, 2013 and which are each hereinincorporated by reference in their respective entirety:

-   -   U.S. Provisional Patent Application Ser. No. 61/812,365,        entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED        BY A SINGLE MOTOR;    -   U.S. Provisional Patent Application Ser. No. 61/812,376,        entitled LINEAR CUTTER WITH POWER;    -   U.S. Provisional Patent Application Ser. No. 61/812,382,        entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;    -   U.S. Provisional Patent Application Ser. No. 61/812,385,        entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION        MOTORS AND MOTOR CONTROL; and    -   U.S. Provisional Patent Application Ser. No. 61/812,372,        entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED        BY A SINGLE MOTOR.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Dec. 28, 2017, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/611,341,        entitled INTERACTIVE SURGICAL PLATFORM;    -   U.S. Provisional Patent Application Ser. No. 62/611,340,        entitled CLOUD-BASED MEDICAL ANALYTICS; and    -   U.S. Provisional Patent Application Ser. No. 62/611,339,        entitled ROBOT ASSISTED SURGICAL PLATFORM.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Mar. 28, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302,        entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED        COMMUNICATION CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294,        entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS        AND CREATE ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300,        entitled SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309,        entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN        OPERATING THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310,        entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291,        entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO        DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296,        entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327,        entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND        AUTHENTICATION TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315,        entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS        NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313,        entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320,        entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307,        entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323,        entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,641, entitled        INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION        CAPABILITIES, now U.S. Patent Application Publication No.        2019/0207911;    -   U.S. patent application Ser. No. 15/940,648, entitled        INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES        AND DATA CAPABILITIES, now U.S. Patent Application Publication        No. 2019/0206004;    -   U.S. patent application Ser. No. 15/940,656, entitled SURGICAL        HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM        DEVICES, now U.S. Patent Application Publication No.        2019/0201141;    -   U.S. patent application Ser. No. 15/940,666, entitled SPATIAL        AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS, now U.S. Patent        Application Publication No. 2019/0206551;    -   U.S. patent application Ser. No. 15/940,670, entitled        COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES        BY INTELLIGENT SURGICAL HUBS, now U.S. Patent Application        Publication No. 2019/0201116;    -   U.S. patent application Ser. No. 15/940,677, entitled SURGICAL        HUB CONTROL ARRANGEMENTS, now U.S. Patent Application        Publication No. 2019/0201143;    -   U.S. patent application Ser. No. 15/940,632, entitled DATA        STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD, now U.S. Patent Application Publication No.        2019/0205566;    -   U.S. patent application Ser. No. 15/940,640, entitled        COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND        STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED        ANALYTICS SYSTEMS, now U.S. Patent Application Publication No.        2019/0200863;    -   U.S. patent application Ser. No. 15/940,645, entitled SELF        DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT, now        U.S. Pat. No. 10,892,899;    -   U.S. patent application Ser. No. 15/940,649, entitled DATA        PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN        OUTCOME, now U.S. Patent Application Publication No.        2019/0205567;    -   U.S. patent application Ser. No. 15/940,654, entitled SURGICAL        HUB SITUATIONAL AWARENESS, now U.S. Patent Application        Publication No. 2019/0201140;    -   U.S. patent application Ser. No. 15/940,663, entitled SURGICAL        SYSTEM DISTRIBUTED PROCESSING, now U.S. Patent Application        Publication No. 2019/0201033;    -   U.S. patent application Ser. No. 15/940,668, entitled        AGGREGATION AND REPORTING OF SURGICAL HUB DATA, now U.S. Patent        Application Publication No. 2019/0201115;    -   U.S. patent application Ser. No. 15/940,671, entitled SURGICAL        HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER,        now U.S. Patent Application Publication No. 2019/0201104;    -   U.S. patent application Ser. No. 15/940,686, entitled DISPLAY OF        ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE, now        U.S. Patent Application Publication No. 2019/0201105;    -   U.S. patent application Ser. No. 15/940,700, entitled STERILE        FIELD INTERACTIVE CONTROL DISPLAYS, now U.S. Patent Application        Publication No. 2019/0205001;    -   U.S. patent application Ser. No. 15/940,629, entitled COMPUTER        IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS, now U.S. Patent        Application Publication No. 2019/0201112;    -   U.S. patent application Ser. No. 15/940,704, entitled USE OF        LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE        PROPERTIES OF BACK SCATTERED LIGHT, now U.S. Patent Application        Publication No. 2019/0206050;    -   U.S. patent application Ser. No. 15/940,722, entitled        CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF        MONO-CHROMATIC LIGHT REFRACTIVITY, now U.S. Patent Application        Publication No. 2019/0200905; and    -   U.S. patent application Ser. No. 15/940,742, entitled DUAL CMOS        ARRAY IMAGING, now U.S. Patent Application Publication No.        2019/0200906.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,636, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES, now U.S. Patent        Application Publication No. 2019/0206003;    -   U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL HUBS, now U.S. Patent        Application Publication No. 2019/0201114;    -   U.S. patent application Ser. No. 15/940,660, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER, now U.S. Patent Application        Publication No. 2019/0206555;    -   U.S. patent application Ser. No. 15/940,679, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS        WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET, now        U.S. Patent Application Publication No. 2019/0201144;    -   U.S. patent application Ser. No. 15/940,694, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED        INDIVIDUALIZATION OF INSTRUMENT FUNCTION, now U.S. Patent        Application Publication No. 2019/0201119;    -   U.S. patent application Ser. No. 15/940,634, entitled        CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION        TRENDS AND REACTIVE MEASURES, now U.S. Patent Application        Publication No. 2019/0201138;    -   U.S. patent application Ser. No. 15/940,706, entitled DATA        HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK, now        U.S. Patent Application Publication No. 2019/0206561; and    -   U.S. patent application Ser. No. 15/940,675, entitled CLOUD        INTERFACE FOR COUPLED SURGICAL DEVICES, now U.S. Pat. No.        10,849,697.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,627, entitled DRIVE        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S.        Patent Application Publication No. 2019/0201111;    -   U.S. patent application Ser. No. 15/940,637, entitled        COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS, now U.S. Patent Application Publication No.        2019/0201139;    -   U.S. patent application Ser. No. 15/940,642, entitled CONTROLS        FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S. Patent        Application Publication No. 2019/0201113;    -   U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC        TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S.        Patent Application Publication No. 2019/0201142;    -   U.S. patent application Ser. No. 15/940,680, entitled        CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S.        Patent Application Publication No. 2019/0201135;    -   U.S. patent application Ser. No. 15/940,683, entitled        COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS, now U.S. Patent Application Publication No.        2019/0201145;    -   U.S. patent application Ser. No. 15/940,690, entitled DISPLAY        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S.        Patent Application Publication No. 2019/0201118; and    -   U.S. patent application Ser. No. 15/940,711, entitled SENSING        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, now U.S.        Patent Application Publication No. 2019/0201120.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

A surgical stapling system can comprise a shaft and an end effectorextending from the shaft. The end effector comprises a first jaw and asecond jaw. The first jaw comprises a staple cartridge. The staplecartridge is insertable into and removable from the first jaw; however,other embodiments are envisioned in which a staple cartridge is notremovable from, or at least readily replaceable from, the first jaw. Thesecond jaw comprises an anvil configured to deform staples ejected fromthe staple cartridge. The second jaw is pivotable relative to the firstjaw about a closure axis; however, other embodiments are envisioned inwhich the first jaw is pivotable relative to the second jaw. Thesurgical stapling system further comprises an articulation jointconfigured to permit the end effector to be rotated, or articulated,relative to the shaft. The end effector is rotatable about anarticulation axis extending through the articulation joint. Otherembodiments are envisioned which do not include an articulation joint.

The staple cartridge comprises a cartridge body. The cartridge bodyincludes a proximal end, a distal end, and a deck extending between theproximal end and the distal end. In use, the staple cartridge ispositioned on a first side of the tissue to be stapled and the anvil ispositioned on a second side of the tissue. The anvil is moved toward thestaple cartridge to compress and clamp the tissue against the deck.Thereafter, staples removably stored in the cartridge body can bedeployed into the tissue. The cartridge body includes staple cavitiesdefined therein wherein staples are removably stored in the staplecavities. The staple cavities are arranged in six longitudinal rows.Three rows of staple cavities are positioned on a first side of alongitudinal slot and three rows of staple cavities are positioned on asecond side of the longitudinal slot. Other arrangements of staplecavities and staples may be possible.

The staples are supported by staple drivers in the cartridge body. Thedrivers are movable between a first, or unfired position, and a second,or fired, position to eject the staples from the staple cavities. Thedrivers are retained in the cartridge body by a retainer which extendsaround the bottom of the cartridge body and includes resilient membersconfigured to grip the cartridge body and hold the retainer to thecartridge body. The drivers are movable between their unfired positionsand their fired positions by a sled. The sled is movable between aproximal position adjacent the proximal end and a distal positionadjacent the distal end. The sled comprises a plurality of rampedsurfaces configured to slide under the drivers and lift the drivers, andthe staples supported thereon, toward the anvil.

Further to the above, the sled is moved distally by a firing member. Thefiring member is configured to contact the sled and push the sled towardthe distal end. The longitudinal slot defined in the cartridge body isconfigured to receive the firing member. The anvil also includes a slotconfigured to receive the firing member. The firing member furthercomprises a first cam which engages the first jaw and a second cam whichengages the second jaw. As the firing member is advanced distally, thefirst cam and the second cam can control the distance, or tissue gap,between the deck of the staple cartridge and the anvil. The firingmember also comprises a knife configured to incise the tissue capturedintermediate the staple cartridge and the anvil. It is desirable for theknife to be positioned at least partially proximal to the rampedsurfaces such that the staples are ejected ahead of the knife.

A stapling instrument 1000 is illustrated in FIG. 1 . The staplinginstrument 1000 comprises a handle 1100, a shaft 1200 extending from thehandle 1100, and a loading unit 1300 that is removably attachable to theshaft 1200. The shaft 1200 comprises a distal connection 1220 that isreleasably attached to a proximal connection end 1320 of the loadingunit 1300. The entire disclosure of U.S. Pat. No. 5,865,361, entitledSURGICAL STAPLING APPARATUS, which issued on Feb. 2, 1999 isincorporated by reference herein. The loading unit 1300 furthercomprises an end effector 1400 and an articulation joint 1500. The endeffector 1400 comprises an anvil jaw 1410 and a cartridge jaw 1420. Thecartridge jaw 1420 is configured to receive a staple cartridge, such asstaple cartridge 1900, for example, and is rotatable between an openunclamped position and a closed clamped position relative to the anviljaw 1410. In various other embodiments, the anvil jaw 1410 is rotatablerelative to the cartridge jaw 1420. In either embodiment, the staplinginstrument 1000 comprises a firing drive actuatable to close the endeffector 1400 and, during a separate actuation (or actuations), fire thestaples from the staple cartridge 1900. Referring to FIG. 1 , the firingdrive includes a firing trigger 1120 which, when actuated (FIG. 2 ),advances a firing rod 1690 distally. When the loading unit 1300 isattached to the shaft 1200, the firing rod 1690 is coupled to a firingmember 1390 of the loading unit 1300 which is advanced distally by thefiring rod 1690 when the firing rod 1690 is advanced distally.

Further to the above, the firing trigger 1120 is actuated a first timeto advance the firing rod 1690 and the firing member 1390 distally toclose the end effector 1400. When the firing trigger 1120 is actuatedtoward a grip 1110 of the handle 1100, the firing trigger 1120compresses a trigger spring, such as a torsion spring, for example,between the firing trigger 1120 and a frame of the handle 1100. Thefiring trigger 1120 is then released and the trigger spring returns thefiring trigger 1120 back into its unactuated position. Notably, thefiring rod 1690 and the firing member 1390 are not retracted proximallywhen the firing trigger 1120 is returned to its unactuated position.Instead, the firing rod 1690 and the firing member 1390 remain in theirdistally-advanced positions. The firing drive further comprises aretraction knob 1710 coupled to the firing rod 1690. If the clinician isunsatisfied with the positioning of the jaws 1410 and 1420 on thepatient tissue, the clinician can pull the retraction knob 1710proximally to manually retract the firing rod 1690 and the firing member1390 proximally and open the end effector 1400. In at least oneembodiment, the end effector 1400 comprises one or more springs, such ascoil springs, for example, positioned between the jaws 1410 and 1420such that the springs push the end effector 1400 open when the firingmember 1390 is retracted by the firing rod 1690.

If the clinician is satisfied with the position of the jaws 1410 and1420 on the patient tissue, further to the above, the clinician candepress a mode switch, which is discussed further below. When depressed,the mode switch electronically and/or mechanically shifts the staplinginstrument 1000 from a closure mode to a staple firing mode. As aresult, a second actuation of the firing trigger 1120 drives the firingrod 1690 and firing member 1390 distally through a firing stroke toeject staples from the staple cartridge 1900. In at least oneembodiment, the staple firing stroke is about 15 mm, for example. Insome embodiments, a 15 mm staple firing stroke is sufficient to fire allof the staples of the staple cartridge 1900 while, in other embodiments,more than one staple firing stroke is needed to fire all of the staplesfrom the staple cartridge 1900. In such multi-stroke embodiments, thefiring trigger 1120 is releasable after the second actuation and thenreactuated a third time to produce a second staple firing stroke. Likethe first staple firing stroke, the second staple firing stroke is alsoabout 15 mm. In various embodiments, the firing trigger 1120 isactuatable to produce a third staple firing stoke and/or a fourth staplefiring stroke, or as many firing strokes that are needed, to fire all ofthe staples of the staple cartridge 1900. Regardless of the number ofstaple firing strokes needed to fully fire the staple cartridge 1900,the clinician can pull the retraction actuator 1710 proximally afterless than all of the staple firing strokes have been completed to openthe end effector 1400 and remove the stapling instrument 1000 from thepatient. The entire disclosure of U.S. Pat. No. 10,433,842, entitledSURGICAL HANDLE ASSEMBLY, which issued on Oct. 8, 2019, is incorporatedby reference herein.

Further to the above, an entire staple firing stroke can be comprised ofmultiple staple firing actuations, especially in embodiments comprisinga reciprocating mechanism such as those discussed below, for example.That said, in various instances, each staple firing actuation can bereferred to as a staple firing stroke even though each such staplefiring stroke does not fire all of the staples of a staple cartridge. Insuch instances, such staple firing strokes are part of an entire staplefiring stroke to eject all of the staples from a staple cartridge.

A surgical stapling instrument 2000 is illustrated in FIG. 3 . Thestapling instrument 2000 is similar to the stapling instrument 1000 inmany respects which will not be discussed herein for the sake ofbrevity. The stapling instrument 2000 comprises a handle 2100 and afiring drive 2600. The handle 2100 comprises a grip 2110 and a firingactuator 2120 which includes an actuatable switch 2125. The firing drive2600 comprises an electric motor 2630 and a battery 2640 configured tosupply power to the electric motor 2630 through an electronic circuit2620 that is controlled by the firing actuator 2120. The electric motor2630 is mounted in the handle 2100 and comprises a rotatable motoroutput 2635 operably engaged with a gear train 2650 of the drive system2600. The gear train 2650 comprises a drive gear 2655 operably engagedwith a drive crank 2660 of the drive system 2600 which is rotatablymounted to the handle 2100 about a pivot 2665. The drive crank 2660comprises a gear portion comprising gear teeth meshingly engaged withthe drive gear 2655 and is rotatable about the pivot 2665 by the drivegear 2655. The drive system 2600 further comprises a pawl 2670 and afiring rack 2680. The pawl 2670 is rotatably connected to the drivecrank 2660 about a pin 2675 and comprises a drive tooth 2672 configuredto engage a longitudinal array of ratchet teeth 2682 defined on thebottom of the firing rack 2680 and drive the firing rack 2680 distallyalong longitudinal axis LA during a firing stroke.

As discussed above, the electronic circuit 2620 controls the operationof the electric motor 2630 in response to inputs from the firingactuator 2120. In various embodiments, the motor 2630 comprises a directcurrent (DC) motor, for example, but can comprise any suitable motor. Invarious embodiments, the electronic circuit 2620 comprises amicroprocessor comprising at least one input gate in communication withthe firing actuator switch 2125 and at least one output gate incommunication with a relay configured to control the supply of powerfrom the battery 2640 to the electric motor 2630. Although notillustrated in FIG. 3 , the electronic circuit 2620 comprises electricalconductors, wires, and/or flex circuits, for example, which connect thecomponents of the electronic circuit such as the motor 2630 and thebattery 2640, for example. In certain embodiments, the electroniccircuit 2620 does not comprise a microprocessor and, instead, relies onswitch logic to control the operation of the electric motor 2630. Suchembodiments may be advantageous when the stapling instrument 2000 isexposed to a harsh sterilization process, for example. Thus, while thediscussion provided below is presented using an embodiment including amicroprocessor, the reader should appreciate that an equivalent analogcircuit could be used to perform the same functions and operationsdiscussed herein.

In use, referring to FIG. 4 , the firing actuator 2120 is actuated afirst time to close the end effector 1400 of the stapling instrument2000. The actuation of the firing actuator 2120 closes the switch 2125which is detected by the microprocessor. In response, the microprocessorapplies a voltage potential to the electric motor 2630 from the battery2640 to rotate the motor output 2635 in a first direction and drive thepawl 2670 distally. The firing drive comprises a pawl spring 2685mounted to the pawl 2670 and the frame of the handle 2100 which appliesa biasing force to the pawl 2670 to bias the drive tooth 2672 intoengagement with the ratchet teeth 2682 defined on the firing rack 2680.When the pawl 2670 is advanced distally in response to the firstactuation of the firing actuator 2120, referring to FIG. 5 , the pawl2670 drives the firing rack 2680 distally which, in turn, drives thefiring rod 1690 and the firing member 1390 distally to close the endeffector 1400. Stated another way, the pawl 2670, the firing rack 2680,the firing rod 1690, and the firing member 1390 are all advanceddistally a closure stroke in response to the first actuation of thefiring actuator 2120.

After the microprocessor determines that the closure stroke is complete,further to the above, the microprocessor stops the motor 2630 bydisconnecting the voltage potential from the battery 2640. At suchpoint, referring to FIG. 6 , the pawl spring 2685, which was resilientlystretched when the pawl 2670 was advanced distally through the closurestroke, resiliently contracts and pulls the pawl 2670 proximally backinto its unactuated position. Notably, the ratchet teeth 2682 defined onthe firing rack 2680 are shaped to permit the drive tooth 2672 of thepawl 2670 to slide proximally relative to the ratchet teeth 2682 whenthe pawl 2670 is retracted. In such instances, the pawl spring 2685 canbackdrive the electric motor 2630. In various alternative embodiments,the microprocessor can reverse the polarity of the voltage potentialbeing applied to the motor 2630 to operate the motor output 2635 in anopposite direction to drive the pawl 2670 proximally. Such embodimentscan be useful to overcome the inertia of the gear train 2650. Also, insuch embodiments, the firing drive can include a beginning-of-strokesensor in communication with the microprocessor which is closed when thepawl 2670 is retracted back into its unactuated position. When thebeginning-of-stroke sensor is closed, the microprocessor disconnects thevoltage polarity from the motor 2630.

As discussed above, the microprocessor is configured to determine whenthe closure stroke is complete. In various embodiments, the firing drivefurther comprises an encoder in communication with the microprocessorwhich is configured to monitor and count the rotations of the motoroutput 2635. In at least one such embodiment, a magnetic element ispositioned on and/or within the motor output 2635 and the encoder isconfigured to detect the disturbances in a magnetic field created by theencoder when the motor output 2635 is rotated. Once the rotation countreaches a predetermined count threshold, the microprocessor disconnectsand/or reverses the polarity being applied to the motor 2630. In variousembodiments, the firing drive comprises an end-of-stroke sensor incommunication with the microprocessor that is closed by the pawl 2670when the pawl 2670 reaches the end of its stroke. The microprocessor isconfigured to sense the closure of the end-of-stroke sensor and, inresponse, disconnect and/or reverse the polarity being applied to themotor 2630.

After the pawl 2670 has been reset after the closure stroke, theclinician may decide to re-open the end effector 1400 by pulling theretraction knob 1710 proximally or initiate the staple firing stroke. Toinitiate the staple firing stroke, the clinician must first depress amode switch in communication with the microprocessor, which is discussedfurther below. If the mode switch is not depressed, the microprocessorand motor 2630 are not responsive to a subsequent actuation of thefiring actuator 2120. After the mode switch is depressed, referring toFIG. 7 , the microprocessor and motor 2630 are responsive to asubsequent actuation of the firing actuator 2120. In such instances, themotor output 2635 is rotated in the first direction once again to drivethe pawl 2670 distally through a second actuation stroke. In thisactuation stroke, the pawl 2670 drives the firing member 1390 partiallythrough the staple cartridge 1900 to eject staples therefrom. Once thepawl 2670 reaches the end of the second actuation stroke, the pawl 2670closes the end-of-stroke switch and the microprocessor reverses thepolarity of the voltage being applied to the electric motor 2630 suchthat the direction of the motor output 2635 is reversed and the pawl2670 is retracted. This process is repeated automatically until eitherthe microprocessor determines that the maximum number of staple firingstrokes has been performed or the clinician releases the firing actuator2120. In various instances, each staple firing stroke is about 15 mm,for example, and in embodiments configured to deploy a 60 mm staplepattern, for example, the maximum number of staple firing strokes isfour. In such instances, the pawl 2670 would be reciprocated once forthe closure stroke and then four times to deploy the staples.

If the clinician releases the firing actuator 2120 prior to the maximumnumber of staple firing strokes being reached, further to the above, themicroprocessor disconnects the voltage polarity from the electric motor2630. In various embodiments, the inertia of the gear train 2650 holdsthe pawl 2670 in position and the firing drive is held in a pausedcondition. In certain embodiments, in such instances, the microprocessorcan apply a voltage potential to the electric motor 2630 that issufficient to temporarily hold the pawl 2670 in position. If theclinician no longer wishes to continue deploying the staples, theclinician can pull the retraction knob 1710 proximally to retract thefiring rack 2680 proximally. To reset the stapling firing rive in suchinstances, the clinician can depress the mode switch once again whichcauses the microprocessor to return the pawl 2670 back into itsunactuated position. If the clinician wishes to continue deploying thestaples, on the other hand, the clinician can re-depress the firingactuator 2120 to re-start the motor 2630.

As discussed above, the stapling instrument 2000 can comprise an analogcontrol circuit for controlling the above-described series ofoperations. Referring to FIG. 9 , the stapling instrument 2000 cancomprise a control circuit 2620′ configured to control the operation ofthe motor 2630. The control circuit 2620′ comprises a firing actuator2120′, a mode switch 2720′, and a relay 2730′. The firing actuator 2120′comprises a mom-off-mom switch, for example, in communication with themode switch 2720′ and the relay 2730′. The relay 2730′ comprises aset/re-set function capable of reversing the voltage polarity applied tothe motor 2630. The control circuit 2620′ further comprises anend-of-stroke switch 2740 and a beginning-of-stroke switch 2750. Invarious instances, the operation of the motor 2630 is changed orinterrupted if one or both of the switches 2740 and 2750 is opened, forexample. In at least one such embodiment, the end-of-stroke switch 2740is opened by the firing rack 2680 when the firing rack 2680 has beenadvanced through the maximum number of staple firing actuations.Similarly, in at least one such embodiment, the beginning-of-strokeswitch 2750 is opened by the firing rack 2680 when the firing rack 2680has been returned to its proximal unactuated position.

Further to the above, referring to FIG. 8 , the surgical instrument 2000can comprise an end-of-stroke switch 2790 that is closed by the drivegear 2655 at the end of an actuation stroke of the pawl 2670. The drivegear 2655 is fixedly mounted to a gear shaft 2652 and the drive gear2655 is rotatably mounted in the handle 2100 about the gear shaft 2652.The gear shaft 2652 comprises a switch key 2654 extending therefromwhich, during an initial portion of the drive gear 2655 rotation, is notin contact with a ring stack 2780 including a first switch ring 2782 anda second switch ring 2786 which are rotatably supported by the gearshaft 2652 and do not rotate with the gear shaft 2652 during the initialrotation of the drive gear 2655. As the drive gear 2655 is rotated,however, the switch key 2654 contacts the first switch ring 2782 and, asa result, the first switch ring 2782 and the gear shaft 2652 begin torotate together. Notably, though, the second switch ring 2786 does notimmediately rotate with the first switch ring 2782 and the gear shaft2652; rather, the first switch ring 2782 and the gear shaft 2652 rotaterelative to the second switch ring 2786 until a drive shoulder 2784 ofthe first switch ring 2782 contacts the second switch ring 2786. At suchpoint, the gear shaft 2652, the first switch ring 2782, and the secondswitch ring 2786 rotate together until a switch key 2788 of the secondswitch ring 2786 contacts a switch element 2798 of the end-of-strokeswitch 2790 and closes the end-of-stroke switch 2790. The pawl 2670reaching the end of its actuation stroke coincides with the closure ofthe end-of-stroke switch 2790 and the closure of the end-of-strokeswitch 2790 reverses the motor 2630 to retract the pawl 2670.

Referring again to FIG. 3 , the motor 2630 of the stapling instrument2000 is positioned in the grip 2110 of the handle 2100. In various otherembodiments, the motor 2630 is positioned proximally relative to thegrip 2110 within the handle 2100. In at least one such embodiment, themotor 2630 can drive a jack screw arrangement to move the firing rack2680.

A stapling instrument 3000 is illustrated in FIG. 12 . The staplinginstrument 3000 comprises a motor-driven firing system that does not usea pawl. Instead, the firing drive 3600 of the stapling instrument 3000comprises an electric motor 3630 including a gear output 3635, a drivegear 3655 operably intermeshed with the gear output 3635, and a firingrack 3680 including a longitudinal array of gear teeth 3682 intermeshedwith the drive gear 3655. In use, a first voltage polarity is applied tothe motor 3630 to rotate the gear output 3635 in a first direction and asecond, or opposite, voltage polarity is applied to the motor 3630 torotate the gear output 3635 in a second, or opposite, direction. Thefiring rack 3680 and the firing rod 2690 are driven distally when themotor 3630 is operated in the first direction and retracted proximallywhen the motor 3630 is operated in the second direction.

Further to the above, the stapling instrument 3000 comprises a controlcircuit including a firing actuator 2120 comprising a firing actuationswitch 2125 that, when actuated, closes a sub-circuit that applies thefirst voltage polarity to the motor 3630 to advance the firing rack 3670through a closure stroke to close the end effector 1400. The staplinginstrument 3000 further comprises an end-of-closure-stroke switch thatis opened when the firing rack 3680 reaches the end of the closurestroke to stop the electric motor 3630. The stapling instrument 3000also comprises a second, or reverse, actuation switch that, whenactuated, closes a sub-circuit that applies the second voltage polarityto the motor 3630 to retract the firing rack 3680 and the firing rod2690 and open the end effector 1400. Once the end effector 1400 isclosed and the clinician is satisfied with the position of the endeffector 1400 on the patient tissue, the clinician can depress a modeswitch of the control circuit that, when depressed, re-closes theend-of-closure-stroke switch such that the motor 3630 is responsive tothe firing actuator switch 2125 once again. When the firing actuator2120 is re-actuated by the clinician, at such point, the motor 3630 isoperated in the first direction once again to advance the firing rack3680 and the firing rod 2690 distally to perform the staple firingstroke. The stapling instrument 3000 further comprises anend-of-firing-stroke switch that is opened when the firing rack 3680reaches the end of the staple firing stroke to stop the electric motor3630. To retract the firing rack 3680 and the firing rod 2690 back intotheir unfired position, the clinician can depress the reverse actuationswitch to apply the opposite voltage polarity to the electric motor3630.

As discussed above, the motor 3630 is responsive to the actuation switch2125 of the firing actuator 2120 being closed. FIG. 12A depicts a staplefiring circuit 3620 including the actuation switch 2125 and the motor3630 with the actuation switch 2125 being in a closed, or actuated,condition. The control circuit 3620 further comprises a clamp, orend-of-closure-stroke, switch 2770 and an end-of-firing-stroke switch2750. When the end effector 1400 is in an open, or unclamped,configuration, as illustrated in FIG. 12B, the clamp switch 2770 is inan open condition thereby decoupling the battery 2640 from the electricmotor 3630 and preventing the staple firing stroke from being performedeven if the actuation switch 2125 is closed, or actuated, by theclinician. When the end effector 1400 is in a closed, or clamped,configuration, the clamp switch 2770 is closed. The end-of-firing-strokeswitch 2750 is in a normally-closed condition and is opened by thefiring drive at the end of the staple firing stroke, as discussed above,which opens the firing circuit to stop the electric motor 3630.

In various alternative embodiments, the motor 3630 is operated in afirst direction in response to the firing actuator 2120 being actuatedto perform the staple firing stroke. The motor 3630 continues to turn solong as the firing actuator 2120 is depressed and the firing rack 3680is driven distally until the teeth 3682 of the firing rack 3680 run offthe drive gear 3655. At such point, the staple firing stroke is completeand the firing rack 3680 is no longer advanced distally by the motor3630 even though the firing actuator 2120 is depressed. To reset thestaple firing system, the firing actuator 2120 is released and theretraction handle 1710 is pulled proximally to retract the firing rack3680 and the firing rod 2690 back into their unfired positions. In suchinstances, pulling the firing rack 3680 proximally will, absent otherconsiderations, backdrive the motor 3630. In at least one embodiment,the drive gear 3655 can be biased out of engagement with the firing rack3680 as the firing rack 3680 is retracted proximally and then re-engagedwith the firing rack 3680 after the firing rack 3680 has been returnedto its proximal unfired position. In at least one embodiment, the handleof the surgical instrument comprises an actuator, such as a toggleswitch, for example, that is actuated to disengage the drive gear 3655from the firing rack 3680 before the retraction stroke of the firingrack 3680 and then switched back after the retraction stroke of thefiring rack 3680 is completed.

In various embodiments, a surgical stapling instrument comprises anactuator including an actuator switch and an electric motor 3630operated by the actuator which drives the firing rack 3680 distally froma proximal unfired position when the actuator switch is closed. Thestapling instrument further comprises an end-of-stroke switch which,when opened by the firing rack 3680 at the end of the staple firingstroke, automatically reverses the operation of the electric motor 3630to retract the firing rack 3680 proximally. The stapling instrumentfurther comprises a beginning-of-stroke switch which is opened by thefiring rack 3680 when the firing rack 3680 is returned to its proximalunfired position to stop the electric motor 3630. In various alternativeembodiments, the switch logic of such a stapling instrument can compriseone or more normally-open switches instead of a normally-closed switch.In any event, the staple firing stroke is stopped when the actuator isreleased by the clinician. If the clinician desires to return the firingrack 3680 back into its proximal unfired position without finishing thestaple firing stroke, the clinician can retract the firing rack 3680proximally by the retraction handle 1710.

In various embodiments, referring to FIG. 10 , a stapling instrument cancomprise a control circuit 2620″. The control circuit 2620″ comprises adouble pole, double throw momentary switch 2730″ configured to controlthe operation of the motor 2630. The momentary switch 2730″ comprises amom-off-mom switch that is switchable from an off state to a firston-state and a second-on state, but any suitable switch could be used.In the first on-state of the momentary switch 2730″, a first voltagepolarity is applied to the motor 2630 from the battery 2640 whichadvances the firing rack 2680 distally. In the second on-state of themomentary switch 2730″, a second, or opposite, voltage polarity isapplied to the motor 2630 from the battery 2640 which retracts thefiring rack 2680 proximally.

A control circuit 2620′″, which is similar to the control circuit 2620″in many respects, is illustrated in FIG. 11 . In addition to the above,the control circuit 2620′″ further comprises a normally-closedend-of-firing-stroke switch 2750′″ which is opened by the firing rack2680 when the firing rack 2680 reaches the end of the staple firingstroke. In such instances, further to the above, the power supplied tothe motor 2630 from the battery 2640 is disconnected at the end of thestaple firing stroke. At such point, the motor 2630 is no longerresponsive to the first on-state of the momentary switch 2730″. Thatsaid, the motor 2630 is responsive to the second on-state of themomentary switch 2730″. In order to retract the firing rack 2680 backinto its unactuated position, the clinician must close the secondon-state of the momentary switch 2730″ to operate the motor 2630 inreverse. Notably, the control circuit 2620′″ further comprises anormally-closed switch 2740′″ that is opened when the firing rack 2680has been fully retracted. When the switch 2740′″ is opened by the firingrack 2680, the circuit connecting the motor 2630 to the battery 2640 isopened and the motor 2630 is no longer responsive to the second on-stateof the momentary switch 2730″.

In various instances, further to the above, the switch 2750′″ isresettable so that the stapling instrument can be used to perform asecond staple firing stroke after the spent staple cartridge in the endeffector 1400 has been replaced with an unspent staple cartridge. In atleast one embodiment, the switch 2750′″ is manually reset. In at leastone embodiment, the switch 2750′″ comprises a biasing element, orfeature, configured to automatically reset the switch 2750′″ when thefiring rack 2680 is retracted. In embodiments including amicroprocessor, the switch 2750′″ can be electronically reset. In atleast one embodiment, seating an unspent staple cartridge in the endeffector 1400 can be sensed by the microprocessor which then resets theswitch 2750″″. Similarly, the switch 2740′″ is resettable so that thefiring rack 2680 can be retracted by the motor 2630 after the secondstaple firing stroke. In at least one embodiment, the switch 2740′″ ismanually reset. In at least one embodiment, the switch 2740′″ comprisesa biasing element, or feature, configured to automatically reset theswitch 2740′″ when the firing rack 2680 is advanced distally to performthe second staple firing stroke. In embodiments including amicroprocessor, the switch 2740′″ can be electronically reset. In atleast one embodiment, seating an unspent staple cartridge in the endeffector 1400 can be sensed by the microprocessor which then resets theswitch 2740″″.

A firing drive including a ratcheting solenoid mechanism is illustratedin FIGS. 13 and 13A. The firing drive comprises a solenoid 4630including a linear actuator 4635 which is moved proximally and distallyby the solenoid 4630, depending on the voltage polarity applied to thesolenoid 4630. When a first voltage polarity is applied to the solenoid,the linear actuator 4635 is advanced distally. Notably, the linearactuator 4635 comprises a slot and a pawl element 4632 movably seatedwithin the slot which is biased into engagement with the firing rack2680 by a biasing element, such as a spring 4634, for example, containedin the linear actuator 4635. When the linear actuator 4635 is advanceddistally, the pawl element 4632 is engaged with the pawl teeth 2682defined in the bottom of the firing rack 2680 which drives the firingrack 2680 distally. At the end of the actuation stroke of the solenoid4630, a second, or opposite, voltage polarity is applied to the solenoid4630 to retract the linear actuator 4635 proximally. In such instances,the pawl element 4632 can slide relative to the pawl teeth 2682 definedin the firing rack 2680. Once the linear actuator 4635 has beenretracted, the first voltage polarity can be applied to the solenoidonce again to perform another actuation stroke. This process can berepeated until the closing stroke and/or staple firing stroke has beencompleted. In various instances, further to the above, the firstactuation stroke of the linear actuator 4635 closes the end effector1400 and the second actuation stroke, and any subsequent actuationstrokes, fire the staples from the staple cartridge, for example.

In various embodiments, a surgical stapling instrument can comprise anelectric motor including a rotatable output, a drive gear operablyengaged with the rotatable output, and a pawl pivotably mounted to thedrive gear. The pawl is engaged with a longitudinal rack of ratchetteeth defined on a firing rack and is configured to drive the firingrack distally when the drive gear is rotated in a first direction andslide relative to the firing rack when the drive gear is rotated in anopposite direction. To advance the firing rack through a staple firingstroke, the voltage polarity applied to the electric motor is repeatedlyflipped between a positive polarity and a negative polarity to drive thegear back and forth within a drive range that is less than a fullrotation of the drive gear.

A surgical stapling instrument 5000 including a handle 5100 and a firingdrive 5600 is illustrated in FIGS. 14-18 . The stapling instrument 5000is similar to the stapling instruments 1000 and 2000 and other staplinginstrument disclosed herein in many respects, most of which will not bediscussed herein for the sake of brevity. The firing dive 5600 comprisesan electric motor 5630 including a helical gear output 5635 meshinglyengaged with a rack of teeth 5655 defined on a slideable rack 5650. Whena first polarity is applied to the motor 5630 owing to the actuation ofa firing actuator 5120, the motor 5630 is rotated in a first directionwhich drives the rack 5650 from an unactuated position (FIG. 14 ) to anactuated position (FIG. 15 ). Similar to the above, the staplinginstrument 5000 comprises an end-of-actuation sensor 2750 which changesstate in response to the rack 5650 reaching its fully-actuated positionto stop the motor 5630. The firing drive 5600 further comprises a drivecrank 5660 pivotably mounted to the handle 5100 about one of a firstpivot 5722 and a second pivot 5724, as discussed further below. Thedrive crank 5660 is coupled to the rack 5650 at a connection whichallows the rack 5650 to drive the drive crank 5660 about its pivot and,at the same time, permit the drive crank 5660 to rotate relative to therack 5650. In at least one instance, the drive crank 5660 comprises apin 5661 which extends into a pin slot 5651 defined in the rack 5650which permits such relative motion therebetween. The firing drive 5600further comprises a pawl 5670 rotatably supported in a seat defined inthe opposite end of the drive crank 5660 about a pawl pin 5675. Thefiring drive 5600 also comprises a firing rack 5680 which is sliddistally by the pawl 5670, as discussed below.

Further to the above, the pawl 5670 comprises two drive teeth—a closuretooth 5674 and a staple firing tooth 5672. The closure tooth 5674 is inan extended position (FIGS. 14 and 15 ) during the initial actuation ofthe firing drive 5600 and a retracted position (FIGS. 16-18 ) after theinitial actuation. When the closure tooth 5674 is in its extendedposition, referring to FIG. 14 , the closure tooth 5674 extends into aclosure drive aperture 5684 defined in the firing rack 5680 and, whenthe pawl 5670 is advanced distally during the initial actuation,referring to FIG. 15 , the closure tooth 5674 pushes the firing rack5680 and the firing rod 2690 distally through a closure stroke to closethe end effector 1400. At such point, the electric motor 5630 isoperated in a second, or opposite, direction to drive the rack 5650 backinto its unactuated position, as illustrated in FIG. 16 . Similar to theabove, the stapling instrument 5000 comprises a beginning-of-actuationsensor 2740 which changes state in response to the rack 5650 reachingits fully-retracted position to stop the motor 5630. Notably, theclosure tooth 5674 is in its retracted position when the pawl 5670 isreset by the rack 5650. In this embodiment, the closure tooth 5674 ispivotably coupled to the pawl 5670 and, when the pawl 5670 is retractedproximally after the initial actuation, the closure tooth 5674 contactsa backwall of the closure drive aperture 5684 and is rotated, orflipped, downwardly into its retracted position. In various alternativeembodiments, a pawl tooth actuator in communication with a controller ofthe surgical instrument 5000 controls the position of the closure tooth5674.

Referring again to FIG. 14 , the drive crank 5660 further comprises aplate 5655 mounted thereto. The plate 5655 is mounted to the drive crank5660 such that the plate 5655 rotates with the drive crank 5660. Thefiring drive 5600 further comprises a retraction spring 5685—coupled tothe plate 5655 and the frame of the handle 5100—which resilientlystretches when the drive crank 5660 is rotated distally to drive thepawl 5670 through an actuation stroke. At the end of the actuationstroke, as discussed above, an end-of-actuation switch is opened andpower is no longer supplied to the motor 5630. As also discussed above,an opposite polarity can be applied to the motor 5630 to drive the drivecrank 5660 and the pawl 5670 proximally after the actuation stroke. Thatsaid, the retraction spring 5685 can resiliently contract to pull thedrive crank 5660 and pawl 5670 proximally after the actuation strokewithout the motor 5630 being operated in reverse. In such instances, theproximal movement, or retraction, of the drive crank 5660 and the pawl5670 can be limited by a physical stop in the handle 5100. In any event,the motor 5630 can be actuated a second time to advance the drive crank5660 and pawl 5670 distally once again. During the second actuation,however, the closure tooth 5674 is in its retracted position and notengaged with the firing rack 5680. Instead, referring to FIG. 17 , thestaple firing tooth 5672 of the pawl 5670 is engaged with the ratchetteeth 5682 defined on the bottom of the firing rack 5680. Thus, duringthe second actuation, the pawl 5670 drives the firing rack 5680 distallyvia the staple firing tooth 5672 to eject staples from the staplecartridge. The reciprocation of the pawl 5670 can be repeated until allof the staples from the staple cartridge have been ejected. In variousembodiments, two actuations, or reciprocations, of the pawl 5670 ejectall of the staples while, in other embodiments, all of the staples ofthe staple cartridge are ejected as a result of four actuations of thepawl 5670, for example. In various embodiments, a separate actuation ofthe firing actuator 5120 is required to perform each actuation of thefiring drive 5600. In other embodiments, a first actuation of the firingactuator 5120 performs the initial, or closure, actuation while a secondactuation of the firing actuator 5120 performs all of the staple firingactuations sequentially unless the firing actuator 5120 is released.

Further to the above, the stapling instrument 5000 transitions betweenfrom an end effector closure mode to a staple firing mode between thefirst, or closure, actuation of the motor 5630 and the second, or staplefiring, actuation of the motor 5630. Further to the above, the staplinginstrument 5000 comprises a mode switch which must be depressed by aclinician after the closure actuation to place the stapling instrument5000 in the staple firing mode such that the stapling instrument isresponsive to a second actuation of the firing actuator 5120 to performthe staple firing actuation. If the clinician does not depress the modeswitch after the closure actuation, the motor 5630 is not responsive tothe second actuation of the firing actuator 5120. The staplinginstrument 5000 further comprises a controller, such as a processor, forexample, in communication with the switches and/or sensors of thestapling instrument 5000.

The stapling instrument 5000 also comprises a status indicator array5800 in communication with the processor. The status indicator array5800 comprises a first indicator 5810, a second status indicator 5820,and a third status indicator 5830, but could comprise any suitablenumber of indicators. Each status indicator 5810, 5820, and 5830comprises a light emitting diode (LED), for example, in communicationwith the processor. In at least one embodiment, the stapling instrument5000 comprises a sensor configured to detect the presence of an unspentstaple cartridge in the end effector 1400 in communication with theprocessor. If an unspent staple cartridge seated in the end effector1400 is detected by the processor, the processor applies a voltagepotential to the first status indicator 5810 to illuminate the firststatus indicator 5810. If an unspent staple cartridge is not detected bythe processor, the processor does not apply a voltage potential to thefirst status indicator 5810. In at least one embodiment, the staplinginstrument 5000 can comprise a sensor in communication with theprocessor which is configured to detect the attachment of a loading unit1300 to the stapling instrument. If a loading unit 1300 is detected bythe sensor, the processor applies a voltage potential to the secondstatus indicator 5820 to illuminate the second status indicator 5820. Ifa loading unit 1300 is not detected by the sensor, the processor doesnot apply a voltage potential to the second status indicator 5820.

Further to the above, the stapling instrument 5000 further comprises asensor configured to detect the closure of the end effector 1400 incommunication with the processor. If the processor determines that theend effector 1400 is closed, or at least sufficiently closed, theprocessor applies a voltage potential to the third status indicator 5830to illuminate the third status indicator 5830. If the processordetermines that the end effector 1400 is open, the processor does notapply a voltage potential to the third status indicator 5830. Inaddition, the mode switch is in communication with the processor and theprocessor is configured to determine whether or not the mode switch hasbeen depressed. If the processor determines that the mode switch hasbeen depressed, the processor applies a voltage potential to a fourthstatus indicator to illuminate the fourth status indicator. If theprocessor does not determine that the mode switch has been depressed,the processor does not apply a voltage potential to the fourth statusindicator.

When the stapling instrument 5000 is in its end effector closure mode(FIGS. 14 and 15 ), the drive crank 5660 is rotatable about the firstpivot 5722. When the stapling instrument 5000 is in its staple firingmode (FIGS. 17 and 18 ), the drive crank 5660 is instead rotatable aboutthe second pivot 5724. The first pivot 5722 comprises a first pin thatextends into a first pin aperture defined in the drive crank 5660 whenthe mode switch is in an unactuated position. Notably, the second pivot5724 is not engaged with the drive crank 5660 when the mode switch is inthe unactuated position. The second pivot 5724 comprises a second pinthat extends into a second pin aperture defined in the drive crank 5660when the mode switch is in an actuated position. Notably, the firstpivot 5722 is not engaged with the drive crank 5660 when the mode switchis in the actuated position. In at least one embodiment, the mode switchcomprises a rocker switch having two positions—a first position in whichthe first pivot 5722 is engaged with the drive crank 5660 and a secondposition in which the second pivot 5724 is engaged with the drive crank5660. In at least one embodiment, the mode switch is in communicationwith a first solenoid and a second solenoid. When the mode switch is inits first position, the first solenoid is actuated to extend the firstpin and, when the mode switch is in its second position, the secondsolenoid is actuated to extend the second pin.

When the mode switch is in its first position and the staplinginstrument 5000 is in its end effector closure mode, referring to FIG.15 , the drive crank 5660 defines two torque arms about the first pivot5722. More specifically, a first torque arm D1 is defined between thepin 5661 and the first pivot 5722 and a second torque arm L1 is definedbetween the first pivot 5722 and the pawl pin 5675. Notably, the firsttorque arm D1 is longer than the second torque arm L1. When the modeswitch is in its second position and the stapling instrument 5000 is inits staple firing mode, referring to FIG. 17 , the drive crank 5660defines two torque arms about the second pivot 5724. More specifically,a first torque arm D2 is defined between the pin 5661 and the secondpivot 5724 and a second torque arm L2 is defined between the secondpivot 5724 and the pawl pin 5675. Notably, the first torque arm D1 islonger than the second torque arm D2. Also, notably, the torque arm L2is longer than the torque arm L1. As a result of the above, thestaple-firing actuations of the pawl 5670 and the firing rack 5680 arelonger than the end effector closing actuation of the pawl 5670 and thefiring rack 5680. Such an arrangement is useful as a short closureactuation allows the end effector 1400 to be closed quickly and longerstaple firing actuations may reduce the number of pawl reciprocationsthat are needed to complete the entire staple firing stroke.

Further to the above, referring to FIG. 16 , the stapling instrument5000 is switched from its closure mode to its staple firing mode afterthe closure actuation has been completed but before the driver crank5660 and the pawl 5670 are retracted. In this position, the first pinaperture in the drive crank 5660 is aligned with the first pivot 5722and the second pin aperture in the drive crank 5660 is aligned with thesecond pivot 5724. As a result, this particular position of the drivecrank 5660 can be used to switch from the first pivot 5722 to the secondpivot 5724 and, likewise, from the second pivot 5724 back to the firstpivot 5722. That said, any other suitable position of the drive crank5660 can be used to switch between the first pivot and the second pivotin other embodiments. In at least one embodiment, the mode switch is incommunication with the control system of the stapling instrument 5000and the control system is not responsive to the mode switch until afterthe closure stroke has been completed. That said, various otherembodiments are envisioned in which the stapling instrument 5000 isswitchable from a first state to a second state between any twoactuations of the stapling instrument 5000. In such embodiments, forinstance, the controller can switch the stapling instrument 5000 from afirst, or low, leverage state to a second, or high, leverage state inwhich a larger drive force is transmitted to the firing rack 5680 duringa subsequent actuation than during a previous actuation. In at least onesuch embodiment, the clinician can sense that the force beingtransmitted to the staple firing member is high and then selectivelyactuate an actuator in communication with the controller which, inresponse, stops the reciprocation of the driver crank 5660 and the pawl5670 in the transition position and switches the stapling instrumentfrom the first state to the second state. Once the stapling instrumenthas been switched into its second state by the controller, thecontroller is responsive to the firing actuator 5120 to finish thestaple firing stroke.

In various embodiments, further to the above, the controller of astapling instrument is configured to automatically switch the staplinginstrument from a first state to a second state between the pawlreciprocations of a staple firing stroke. In at least one suchembodiment, the controller comprises a sensing system configured tosense the force being transmitted through the firing rack 5680 to thefiring rod 5690 and the firing member 1390 which is configured to switchthe stapling instrument from the first state to the second state whenthe force exceeds a predetermined force threshold. In at least oneembodiment, the sensing system comprises a load cell sensor configuredto directly measure the force being transmitted through the firing rack5680. In at least one embodiment, the sensing system comprises a straingauge mounted to the firing rack 5680 configured to measure the strainin the firing rack 5680 which is a proxy for the force being transmittedthrough the firing rack 5680. In such instances, the sensing systemswitches the stapling instrument from the first state to the secondstate when the measured strain exceeds a predetermined strain threshold.In at least one embodiment the sensing system comprises a current sensorconfigured to measure the current through the electric motor 5630 whichis a proxy for the force being transmitted through the firing rack 5680.In such instances, the sensing system switches the stapling instrumentfrom the first state to the second state when the measured currentexceeds a predetermined current threshold. In any event, in the secondstate of the stapling instrument, the stapling instrument transmits alarger firing load to the firing rack 5680 for the remainder of thestaple firing stroke. In various embodiments, the controller isconfigured to switch the stapling instrument back into the first statewhen the sensed firing load, or a sensed parameter related to the firingload, falls below the corresponding threshold.

In various embodiments, referring to FIG. 19 , a firing drive of astapling instrument can comprise a transmission including a high speed,low torque gear or gear set (a “high speed gear H”) and a low speed,high torque gear or gear set (a “low speed gear L”). In at least onesuch embodiment, the low speed gear L comprises a first low speed gearL1 and the stapling instrument further comprises a second low speed gearL2. The second low speed gear L2 is slower than the first low speed gearL1 and has a higher torque than the first low speed gear L1. That said,a transmission can comprise any suitable number of gears or gear sets.In use, the stapling instrument shifts between the high speed gear H,the first low speed gear L1, and the second low speed gear L2. Thetransmission comprises an automatic transmission configured to shiftfrom the high speed gear H to the first low speed gear L1 when the forcetransmitted through the firing drive exceeds a first force threshold F1.The automatic transmission is also configured to shift from the firstlow speed gear L1 to the second low speed gear L2 when the forcetransmitted through the firing drive exceeds a second force thresholdF2. FIG. 19 comprises a graph 5200 describing the operational steps ofthe stapling instrument and the transmission shifting during thoseoperational steps, as described further below.

At step 5205, further to the above, the firing trigger of the staplinginstrument is closed to clamp the end effector. Neither force thresholdF1 nor force threshold F2 are exceeded during step 5205 and, as aresult, the transmission remains in its high speed gear H. If the forcethreshold F1 had been exceeded during step 5205, the transmission wouldhave shifted from the high speed gear H to the first low speed gear L1.If the force threshold F2 had been exceeded during step 5205, thetransmission would have shifted to the second low speed gear L2. At step5210, the motor is operated in reverse and the end effector isunclamped. During step 5210, the force threshold F1 was exceeded and thetransmission shifted from the high speed gear H to the first low speedgear L1. Notably, the force threshold F2 was not exceeded during step5210 and, thus, the transmission did not shift into the second low speedgear L2. If the force threshold F2 had been exceeded during step 5210,then the transmission would have shifted into the second low speed gearL2. During step 5215, the end effector is re-closed. Notably, the step5215 is operationally similar to the step 5205; however, the step 5215may be operationally different owing to changes in the fluid content ofthe tissue being clamped. Also, notably, the operation of the surgicalinstrument does not require steps 5210 and 5215. Instead, steps 5210 and5215 can be skipped and the operation of the surgical instrument canskip from step 5205 to step 5220 which comprises shifting the staplinginstrument from the end effector closure mode to the staple firing mode,which is discussed below.

Once step 5220 is complete, further to the above, the staple firingstroke can be initiated which is represented by step 5225. During thestaple firing stroke, the firing force can fluctuate greatly. At step5225, the firing force has exceeded the force threshold F1, but not theforce threshold F2. As such, the transmission is in the first low speedgear L1 at the outset of the staple firing stroke. At step 5230, thefiring force has exceeded the force threshold F2 and, as a result, thetransmission is in the second low speed gear L2. The firing force canincrease as the result of the tissue cutting knife of the firing memberand/or the staples passing through tough, dense, and/or thick tissue,for example, during the staple firing stroke. At step 5235, the firingforce fell back below the force threshold F2 but remained above theforce threshold F1 and, as a result, the transmission shifted into thefirst low speed gear L1. Had the firing force fallen back below theforce threshold F1, the transmission would have shifted in the highspeed gear H, as it did during step 5240 which is at the end of thestaple firing stroke. That said, the firing force may not always dropbelow the force threshold F1 at the end of the staple firing stroke and,in such instances, the transmission would not shift into the high speedgear H. In fact, it's possible for the firing force to exceed the forcethreshold F2 at the end of the staple firing stroke which would causethe transmission to shift into the second low gear L2. That said,embodiments are envisioned in which the controller of the staplinginstrument holds the transmission in a particular gear during aparticular part of the staple firing stroke. For instance, embodimentsare envisioned in which the firing drive moves slowly during thebeginning and/or end of the staple firing stroke resulting in a “softstart” and/or “soft stop” to the staple firing stroke. In suchembodiments, the stapling instrument may be in the first low speed gearL1 or the second low speed gear L2 at the beginning and/or end of thefiring stroke regardless of the measured firing force. In any event, thetissue cutting knife is retracted after the staple firing stroke hasbeen completed such that the end effector can be re-opened which isrepresented by step 5250. Notably, the transmission is in the first lowspeed gear L1 during step 5250 despite the fact that there is verylittle force being transmitted through the firing drive. Similar to theabove, in this embodiment, the stapling instrument controller can holdthe transmission in the first low speed gear L1, for example, when thetissue cutting knife is being retracted. The entire disclosures of U.S.Pat. No. 9,028,529, entitled MOTORIZED SURGICAL INSTRUMENT, which issuedon May 12, 2015 and U.S. Pat. No. 8,602,287, entitled MOTOR DRIVENSURGICAL CUTTING INSTRUMENT, which issued on Dec. 10, 2013 areincorporated by reference herein.

As discussed above, a stapling instrument can comprise a shifting deviceto increase the firing force being transmitted through a firing drive.In some instances, though, the increased firing force may exceed thestrength of one or more components in the firing drive. In variousembodiments, a firing drive can comprise a slip clutch to limit theforce transmitted by the firing drive. One such stapling instrument,i.e., stapling instrument 6000, is illustrated in FIG. 20 . The staplinginstrument 6000 is similar to the stapling instruments 1000 and 2000 andother stapling instruments disclosed herein in many respects, most ofwhich will not be discussed herein for the sake of brevity. The staplinginstrument 6000 comprises a handle 6100, a firing drive 6600, and acontroller 6800. The handle 6000 comprises a grip 6110 and a rotatablefiring trigger 6120. The firing drive 6600 comprises a motor 6630, agear train 6650 operably engaged with the motor 6630, a slip clutch 6670operably engaged with a drive gear 6654 of the gear train 6650, a firingrack 6680 operably engaged with the slip clutch 6670, and a firing rod6690 mounted to and translatable with the firing rack 6680. Thecontroller 6800 is in communication with the motor 6630, a battery 2640,and a firing trigger switch 6125 which is closed by the firing trigger6120 when the firing trigger 6120 is actuated. When the controller 6800detects that the firing trigger switch 6125 has been closed, thecontroller 6800 supplies power to the electric motor 6630 from thebattery 2640.

Further to the above, referring to FIG. 20A, the slip clutch 6670comprises an input gear 6674 including a full circumference of gearteeth (not illustrated) operably engaged with the drive gear 6654 of thegear train 6650. The slip clutch 6670 further comprises an output gear6672 operably engaged with a longitudinal array of teeth 6682 defined onthe bottom of the firing rack 6680. The slip clutch 6670 furthercomprises a shaft 6676 and a bearing 6675 which rotatably supports theshaft 6676. The input gear 6674 is fixedly mounted to the shaft 6676such that the rotation of the input gear 6674 is transmitted to theshaft 6676. The slip clutch 6670 further comprises an array of annularclutch plates 6678 mounted to the shaft 6676 and an array of annularfriction plates 6679 mounted to the output gear 6672 which are engagedwith the clutch plates 6678. When the static friction threshold betweenthe clutch plates 6678 and the friction plates 6679 is not exceeded, theoutput gear 6672 rotates with the shaft 6676 and the input gear 6674. Onthe other hand, the clutch plates 6678, the shaft 6676, and the inputgear 6674 slip relative to the friction plates 6679 and the output gear6672 when the static friction threshold between the clutch plates 6678and the friction plates 6679 has been exceeded. As a result, the firingforce that can be transmitted to the firing rack 6680 is limited by theslip clutch 6670.

Further to the above, a surgical stapling instrument can comprise anysuitable force limiting device to prevent the staple firing drive frombeing overloaded. In at least one such embodiment the bottom of thefiring rack comprises a rough surface and the gear drive comprises afriction wheel including a grit perimeter in contact with the roughsurface. When the force transmitted from the friction wheel to thefiring rack is below the static friction threshold, the friction wheeldrives the firing rack proximally or distally depending on the directionin which the friction wheel is rotated. When the force transmitted fromthe friction wheel to the firing rack exceeds the static frictionthreshold, the friction wheel slips relative to the firing rack and doesnot drive the firing rack.

A stapling instrument 7000 is illustrated in FIG. 21 and is similar tothe stapling instruments 1000 and 2000 and other stapling instrumentsdisclosed herein in many respects, most of which are not discussedherein for the sake of brevity. The stapling instrument 7000 comprises ahandle 7100 and a firing drive 7600. The firing drive 7600 comprises anelectric motor 7630, a gear train 7650, a firing rack 7680, and a firingrod 7690 mounted to the firing rack 7680. The gear train 7650 comprisesa planetary gear arrangement 7654 operably coupled to an output of theelectric motor 7630 and a drive gear 7652 which operably couples theplanetary gear arrangement 7654 to the firing rack 7680. The motor 7630is operated in a first direction when a first voltage potential issupplied to the motor 7630 from a battery 2640 in response to anactuation of a firing actuator 6120. In such instances, the gear train7650 drives the firing rack 7680 and firing rod 7690 distally. The motor7630 is operated in an opposite direction when an opposite polarity isapplied to the motor 7630 from the battery 2640. In such instances, thegear train 7650 drives the firing rack 7680 and the firing rod 7690proximally. In various instances, however, the motor 7630 may failand/or the battery 2640 may not be able to suitably supply power themotor 7630 to retract the firing rack 7680 and the firing rod 7690. Assuch, the stapling instrument 7000 further comprises a manually-drivenbailout drive 7900 which is operable to retract the firing rack 7680 andfiring rod 7690 proximally, as discussed below.

The bailout drive 7900, referring again to FIG. 21 , comprises a bailoutlever 7902 rotatably mounted to a housing of the handle 7100 and abailout rack 7904 coupled to the bailout lever 7902 at a pin joint 7903which transmits the motion of the bailout lever 7902 to the bailout rack7904. The bailout rack 7904 comprises an array of teeth 7906 definedthereon which are meshingly engaged with a bailout gear 7656 of the geardrive 7650. When the bailout lever 7902 is in a stowed position, i.e.,in a position lying flat against the handle housing, the bailout rack7904 is not engaged with the bailout gear 7656. In such instances, thebailout gear 7656 rotates relative to the bailout rack 7904 when thegear drive 7650 is driven by the electric motor 7630. When the bailoutlever 7902 is moved out of its stowed position, i.e., rotated away fromthe handle housing, the bailout lever 7902 is rotated into an engagedposition in which the bailout rack 7904 is engaged with the bailout gear7656. At such point, the bailout lever 7902 is rotatably cranked fromits engaged position to an actuated position to drive the bailout rack7904 upwardly and rotate the bailout gear 7656. Notably, the bailoutgear 7656 and the planetary gear arrangement 7654 are driven by a commoninput shaft in the gear train 7650 such that, when the bailout gear 7656is driven by the rack 7904, the bailout gear 7656 drives the planetarygear arrangement 7654 which drives the firing rack 7680 and firing rod7690 proximally. In such instances, the tissue cutting knife in the endeffector 1400 is retracted proximally such that the end effector 1400can be opened and released from the patient tissue. In variousembodiments, a single actuation of the bailout lever 7902 sufficientlyopens the end effector 1400. In other embodiments, the bailout lever7902 is ratcheted back and forth to sufficiently retract the tissuecutting knife. In at least one embodiment, the rack teeth 7906 compriseratchet teeth which slide over the bailout gear 7656 when the bailoutrack 7904 is retracted. In at least one embodiment, the rack 7680 liftsaway from the bailout gear 7656 when the bailout lever 7656 is rotatedfrom its actuated position back into its engaged position and thenre-engages with the bailout gear 7656 when the bailout 7656 isre-actuated. In at least one embodiment, the rack teeth 7906 comprisegear teeth which are operably intermeshed with the teeth of the bailoutgear 7656 and, in this embodiment, the bailout gear 7656 comprises aratchet face engaged with the input shaft extending into the planetarygear arrangement 7654. As a result of the ratchet face being driveablein only one direction, the bailout gear 7656 is not driven by theelectric motor 7630 but is driveable by the bailout drive. In any event,the actuation of the bailout drive 7900 does not destroy the firingdrive 7600 and, as a result, the stapling instrument 7000 can be usedonce again once the issue that required the bailout drive 7900 to beused is resolved.

In various embodiments, a stapling instrument can comprise a firingdrive configured to advance and retract a firing rack and bailout driveconfigured to retract the firing rack. In at least one such embodiment,the firing drive comprises a firing gear drive operably engaged with thefiring rack which drives and/or retracts the firing rack in response toa rotational input. The bailout drive comprises a bailout gear drivewhich is selectively engageable with the firing drive. Morespecifically, the stapling instrument comprises a shiftable gear whichis shiftable between a first position in which the

A stapling instrument 5000′ is illustrated in FIG. 22 and is similar tothe stapling instruments 1000 and 5000 and other stapling instrumentsdisclosed herein in many respects, most of which will not be discussedherein for the sake of brevity. The stapling instrument 5000′ comprisesa handle 5100′ including a firing drive 5600′ which includes the motor5630 powered by the battery 2640, the rack 5650 which is driven by themotor 5630, and the drive crank 5660 which is driven by the rack 5650.The firing drive 5600′ is operated in a similar manner to that of thefiring drive 5600, but the firing drive 5600′ further comprises a pawl5670′ instead of the pawl 5670 and a firing rack 5680′ instead of afiring rack 5680. Unlike the pawl 5670, the pawl 5670′ comprises asingle drive tooth 5672′ which engages a longitudinal array of ratchetteeth 5682′ defined on the bottom of the firing rack 5680′ to drive thefiring rack 5680′ distally during every actuation, or reciprocation, ofthe pawl 5670′.

Further to the above, the stapling instrument 5000′ further comprises acontrol system including an indicator array 5800′ configured to indicatethe status of the stapling instrument 5000′. The indicator array 5800′comprises four indicator lights 5810, 5820, 5830, and 5840, but couldcomprise any suitable number of indicator lights. The control systemfurther comprises a proximal switch 2740′ and a distal switch 2750′.When the firing rack 5680′ is in its proximal-most, unactuated, position(FIG. 22 ), the firing rack 5680′ is in contact with the proximal switch2740′ which holds the proximal switch 2740′ in an open state. Thestapling instrument 5000′ further comprises a mode switch 5720′ incommunication with the indicator array 5800′ that is switchable betweena first position to place the stapling instrument 5000′ in an endeffector closure mode and a second position to place the staplinginstrument 5000′ in a staple firing mode. When the mode switch 5720′ isin its first position and the firing rack 5680′ is in its proximal-mostposition, referring now to FIG. 22A, the indicator light 5840 isilluminated by the battery 2640. When the firing rack 5680′ is advanceddistally to perform the closure stroke, the firing rack 5680′ disengagesfrom the proximal switch 2740′ which allows the proximal switch 2740′ toclose. In such instances, the indicator light 5840 is no longerilluminated and, instead, the indicator light 5830 is illuminated. Thischange in the indicator lights indicates to the clinician that the endeffector 1400 is closed. Once the mode switch 2740′ is shifted to itssecond position, neither of the indicator lights 5830 and 5840 areilluminated and, instead, the indicator light 5810 is illuminated owingto the distal switch 2750′ being in a normally-closed condition. At theend of the staple firing stroke, the firing rack 5680′ contacts thedistal switch 2750′ and opens the distal switch 2750′. In suchinstances, the indicator light 5810 is no longer illuminated and,instead, the indicator light 5820 is illuminated. This change in theindicator lights indicates to the clinician that the staple firingstroke has been completed.

In various embodiments, a surgical stapling instrument comprises afiring drive including an electric motor and a firing rack drivendistally by the electric motor to perform a closure stroke and then astaple firing stroke. In at least one embodiment, the firing drivefurther comprises a closure actuator and a separate firing actuator incommunication with a processor of the stapling instrument. When theclosure actuator is actuated to close the end effector, the electricmotor is rotated in a first direction to drive the firing rack distally.When the end effector is closed, the processor stops the electric motor.That said, the processor is not responsive to an actuation of the firingactuator while the end effector is open. After the end effector has beenclosed, the processor is no longer responsive to an actuation of theclosure actuator. To open the end effector, at such point, the firingrack is retraced proximally when a retraction knob extending from thefiring rack is pulled proximally. Once the end effector has been closed,the processor is now responsive to an actuation of the firing actuatorto operate the electric motor in the first direction to perform thestaple firing stroke. Once the staple firing stroke has been completed,the processor stops the electric motor. Once the electric motor has beenstopped—either at the end of the staple firing stroke or before the endof the staple firing stroke—the firing rack can be retracted proximallyby the retraction knob to re-open the end effector. In variousembodiments, the stapling instrument comprises a retraction actuator incommunication with the processor that, when actuated, operates theelectric motor in an opposite direction to retract the firing rack andopen the end effector.

In various embodiments, a surgical stapling instrument comprises twofiring drives—a manually-driven closure drive and a motor-driven staplefiring drive. The manually-driven closure drive comprises a rotatabletrigger and a firing rack. The trigger is engaged with the firing racksuch that an actuation of the trigger drives the firing rack distallythrough a closure stroke. When the trigger is rotated into its actuatedposition, the trigger is releasably held in its actuated position by atrigger lock. If the clinician wants to re-open the end effector, theclinician can release the trigger lock and allow a trigger spring tobias the trigger back into its unactuated position and drive the firingrack proximally. The motor-driven staple firing drive comprises anelectric motor configured to drive the firing rack distally through astaple firing stroke once the firing rack has been moved through theclosure stroke. The closure stroke moves the firing rack from a proximalunactuated position in which the firing rack is not operably engagedwith the electric motor to an actuated position in which the firing rackis operably engaged with the electric motor. At such point, a firingactuator in communication with the electric motor is actuatable tooperate the electric motor to drive the firing rack through the staplefiring stroke. In at least one embodiment, the electric motor iscontrolled by a processor and, prior to the end effector being closed,the processor is not responsive to an actuation of the firing actuator.Once the end effector has been closed, the processor is responsive tothe firing actuator. In any event, the closure trigger is disengagedfrom the firing rack once the end effector has been closed. In suchinstances, as a result, the staple firing stroke is performed withoutthe closure trigger being operably engaged with the firing rack. Oncethe staple firing stroke has been completed, the processor automaticallyoperates the electric motor in an opposite direction to retract thefiring rack. Alternatively, a retraction knob extending from the firingrack can be pulled proximally to retract the firing rack. When thefiring rack is retracted back to the actuated position, i.e., theposition between the closure stroke and the staple firing stroke, thefiring rack is re-engaged with the closure trigger. Once the firingtrigger is re-engaged with the closure trigger, the closure trigger canbe released to drive the firing rack back into its unactuated positionto re-open the end effector.

Further to the above, a manually-driven closure system allows theclinician to feel the clamping load being applied to the tissue capturedwithin the end effector via the trigger. If the clamping load is high,for instance, the clinician can feel the force needed to clamp the endeffector thereby giving the clinician an intuitive feel of what isoccurring in the end effector. That said, the force needed to drive thefiring rack distally to fire the staples and cut the tissue is oftenvery high, or at least high enough that some clinicians may struggle toadvance the firing rack distally with a manual trigger. A motor-drivenstaple firing drive can alleviate this issue and make the staplinginstrument easy to operate by all clinicians.

In various embodiments, a surgical stapling instrument comprises apneumatic firing drive. The firing drive comprises an air pump incommunication with an air reservoir configured to store compressed airsupplied to the air reservoir from the air pump. The firing drivefurther comprises a normally-closed valve in communication with the airreservoir and a linear air piston. The linear air piston comprises afiring rod that is moved distally when the valve is opened by arotatable trigger. The linear air piston further comprises a pawlrotatably mounted to the firing rod. When the firing rod is drivendistally, the pawl drives a firing rack of the firing drive distallythrough an actuation stroke. When the valve is re-closed, the compressedair in the air piston is exhausted through the valve and the firing rodand the pawl are retracted proximally by a compression spring positionedin the linear air piston. In such instances, the pawl slides proximallyrelative to the firing rack back into an unactuated position. At suchpoint, the valve can be re-opened to drive the pawl and firing rackdistally through another actuation stroke. In various instances, thefirst actuation stroke can comprise a closure stroke to close the endeffector and the second actuation stroke can comprise a staple firingstroke. In such instances, the firing drive can be actuated as manytimes as needed to fire all of the staples from the staple cartridge.

Referring again to FIG. 1 , the loading unit 1300 is removablyattachable to the shaft 1200 of the stapling instrument 1000. In variousinstances, the loading unit 1300 comprises a lock that releasably locksthe loading unit 1300 to the shaft 1200. When the stapling instrument1000 is not positioned in the patient, a clinician can easily move thelock from a locked position to an unlocked position and detach theloading unit 1300 from the shaft 1200. If, however, the loading unit1300 is positioned in a patient, such as through a trocar or tube, forexample, the clinician may not be able to access the lock to disconnectthe loading unit 1300 from the shaft 1200. As a result, the options fora clinician to resolve a failure in the stapling instrument 1000 may belimited. Referring to FIG. 23 , a stapling instrument 8000 comprises ahandle 1100 and a shaft 8200 that is rotatably coupled to the shaft 8200about a rotation joint positioned within a nozzle grip 8210 of the shaft8200. Similar to the stapling instrument 1000, the stapling instrument8000 comprises a loading unit that is releasably attachable to the shaft8200. The stapling instrument 8000 further comprises a loading unit lockrelease 8900 which is configured to unlock the loading unit from theshaft 8200. Notably, the lock release 8900 is supported by the shaft8200 adjacent the handle 1100. More specifically, the lock release 8900comprises an actuator 8910 slideably mounted to the nozzle grip 8210such that a clinician holding the handle 1100 can access the actuator8910 with the same hand and pull the actuator 8910 proximally. The lockrelease 8900 further comprises an elongate lock bar 8990 including afirst end mounted to the actuator 8910 and a second end releasablyengaged with the loading unit lock. When the actuator 8910 is in itsunactuated position, the loading unit is locked to the shaft 8200. Whenthe actuator 8910 is slid into its actuated position, the loading unitlock is unlocked and the shaft 8200 can be detached from the loadingunit. In at least one embodiment, the loading unit lock is rotatablebetween a locked position and an unlocked position when the actuator8910 is moved proximally. The lock release 8900 further comprises aspring configured to bias the actuator 8910 back into its actuatedposition when the clinician releases the actuator 8910. As a result ofthe above, a clinician can easily unlock the loading unit from the shaft8200 to resolve a failure in the stapling instrument 8000, such as whenthe tissue cutting knife in the loading unit becomes stuck during thestaple firing stroke and/or cannot otherwise be retracted.

As discussed above, a stapling instrument can comprise a loading unitthat is removably attached to a shaft of the stapling instrument. Astapling instrument 9000 is illustrated in FIG. 24 and is similar to thestapling instruments 1000, 2000, and 8000 in many respects, most ofwhich will not be discussed herein for the sake of brevity. The staplinginstrument 9000 comprises a handle 9100 and a releasable shaft assembly9200. The shaft assembly 9200 comprises an end effector 1400, anarticulation joint 1500, an elongate portion 9230 extending proximallyfrom the articulation joint 1500, and a proximal attachment end 9240configured to be attached to a rotatable nozzle grip 9210 of the handle9100. The nozzle grip 9210 comprises a door, or hatch, 9220 that isrotatable from a closed position to an open position. When the door 9220is in its closed position, a clinician cannot access the interconnectionbetween the proximal attachment end 9240 and the handle 9100. When thedoor 9220 is in its open position, however, a clinician can access theinterconnection between the proximal attachment end 9240 and the handle9100 and decouple the shaft assembly 9200 from the handle 9100. Theshaft assembly 9200 comprises a shaft frame that is disengageable from aframe of the handle 9100. The shaft assembly 9200 further comprises afiring member 9290 that is disengageable from a firing rack in thehandle 9100 and an articulation actuator that is disengageable from anarticulation input actuator 1510 (FIG. 23 ) supported on the nozzle grip9210. When the shaft assembly 9200 is detached from the handle 9100, theclinician can pull on the proximal end of the firing member 9290 toretract the firing member 9290 proximally and open the end effector1400. Such an arrangement can be particularly useful in situations wherethe end effector 1400 has been inserted into a patient through a trocar,or tube, and the end effector 1400 is stuck on the patient tissue, forexample. In such instances, the firing member 9290 is accessible fromoutside of the patient and the trocar. The entire disclosure of U.S.Pat. No. 7,624,902, entitled SURGICAL STAPLING APPARATUS, which issuedon Dec. 1, 2009 is incorporated by reference herein. A linear pullbailout, such as those described herein, for example, is usable with thestapling instruments disclosed in U.S. Pat. No. 7,624,902, among others.In any event, the shaft assembly 9200 can be re-assembled to the handle9100 and re-used once the issue that required the bailout to be used isresolved.

In various alternative embodiments, referring to FIG. 25 , a shaftassembly 9200′ comprises a nozzle grip 9210′ and an elongate portion9230′ mounted to the nozzle grip 9210′ where the nozzle grip 9210′ isreleasably attachable to a handle. Similar to the handle nozzle grip9210, the shaft nozzle grip 9210′ comprises an openable door, or hatch,9220 rotatably mounted to the nozzle grip 9210′. When the door 9220 isopen, referring primarily to FIG. 25A, the clinician has access to abailout mechanism 9250′ which is actuatable to engage a ratchet pawl9270′ with a longitudinal rack 9280′ defined on the proximal end of afiring member 9290′ extending through the shaft 9200′. Thus, when theshaft assembly 9200′ has been detached from the handle, the cliniciancan manually drive the firing member 9290′ proximally by ratcheting thebailout mechanism 9250′ and open the end effector 1400. The shaftassembly 9200′ can be re-assembled to the handle and re-used once theissue that required the bailout to be used is resolved.

A staple cartridge 10900 for use with a stapling instrument isillustrated in FIG. 26 . The staple cartridge 10900 comprises acartridge body 10910 including a proximal end 10912, a distal end, adeck 10913 extending between the proximal end 10912 and the distal end,and longitudinal rows of staple cavities 10920 defined in the deck10913. The cartridge body 10910 further comprises a longitudinal slot10914 extending from the proximal end 10912 toward the distal end. Thestaple cavities 10920 are arranged in three longitudinal rows on eachside of the longitudinal slot 10914, although embodiments are envisionedin which the staple cavities 10920 are arranged in two longitudinal rowson each side of the longitudinal slot 10914. That said, the staplecavities 10920 can be arranged in any suitable number of longitudinalrows and/or oriented in any suitable manner. A staple is removablystored in each staple cavity 10920; however, alternative embodiments areenvisioned in which a staple is not positioned in each staple cavity10920. In at least one such embodiment, the outermost rows of staplecavities 10920 do not have a staple in each staple cavity 10920. Such anembodiment may provide a more flexible staple line in the stapledtissue. The cartridge body 10910 further comprises lock supports 10916and 10918 extending proximally from the proximal end 10912, which arediscussed in greater detail further below.

The staple cartridge 10900 further comprises staple drivers and a sled10950. The sled 10950 is positioned in the cartridge body 10910 and ismovable from a proximal unfired position to a distal fired position by afiring member 10990 during a staple firing stroke. The sled 10950comprises a center portion 10954 positioned in the longitudinal slot10914 and ramps 10952 positioned on opposite sides of the centralportion 10954. As the sled 10950 is progressed distally by the firingmember 10990 during the staple firing stroke, the ramps 10952 contactthe staple drivers and drive the staple drivers and the staples towardan anvil of the stapling instrument positioned opposite the staplecartridge 10900. The sled 10950 further comprises lock supports 10956and 10958 extending proximally therefrom. When the sled 10950 is in itsproximal unfired position, referring to FIG. 27 , the lock support 10956of the sled 10950 extends under the lock support 10916 of the cartridgebody 10910 and, similarly, the lock support 10958 of the sled 10950extends under the lock support 10918 of the cartridge body 10910. Insuch instances, the sled lock supports 10956 and 10958 co-operate withthe cartridge lock supports 10916 and 10918 to hold a firing lockout ofthe stapling instrument in an unlocked position. More specifically, thefiring lockout comprises two lock arms 10980 rotatably mounted to ashaft of the stapling instrument about pivot pins 10982 which are heldin an unlocked position by the lock supports 10916, 10918, 10956, and10958 when the sled 10950 is in its proximal unfired position, asillustrated in FIG. 27 . In such instances, the distal ends 10988 of thelock arms 10980 are held in position by the lock supports 10916, 10918,10956, and 10958 against a biasing force applied to their proximal endsby springs 10985 compressed between the lock arms 10980 and a shaftframe of the stapling instrument. Moreover, each lock arm 10980 furthercomprises an inwardly-extending lock 10986 that, in such instances, isnot engaged with a lock window 10996 defined in the firing member 10990and, as a result, the firing member 10990 can be moved distally to pushthe sled 10950 through the staple firing stroke.

When the sled 10950 is advanced distally during the staple firingstroke, referring to FIG. 28 , the sled lock supports 10956 and 10958are no longer positioned under the cartridge lock supports 10916 and10918. The cartridge lock supports 10916 and 10918 are not strong enoughby themselves to support the lock arms 10980 in their unlocked positionsowing to the biasing forces being applied to the proximal ends of thelock arms 10980 by the springs 10985. As such, the cartridge locksupports 10916 and 10918, which comprise cantilevers, deflect downwardlyunder the load being applied thereto thereby allowing the lock arms10980 to rotate into the locked positions. Notably, at this point, thefiring member 10990 has already been advanced distally, at leastpartially, and the lock windows 10996 defined in the firing member 10990are no longer aligned with the inwardly-extending locks 10986 of thelock arms 10980. As such, the distal movement of the firing member 10990during the rest of the staple firing stroke is unimpeded by the lockarms 10980. When the firing member 10990 is retracted back into itsunactuated position after the staple firing stroke, however, theinwardly-extending locks 10986 of the lock arms 10980 swing into thelock windows 10996 of the firing member 10990. In such instances, thelock arms 10980 provide a gate that prevents the firing member 10990from being advanced distally through another staple firing strokethrough the now-spent staple cartridge 10900 positioned in the cartridgejaw. In order to reset the stapling instrument so that it can be usedonce again, the spent staple cartridge 10900 must be removed from thecartridge jaw and replaced with another unspent staple cartridge 10900.In such instances, the lock arms 10980 are rotated back into theirunlocked positions by the lock supports 10916, 10918, 10956, and 10958of the new, or unspent, staple cartridge 10900. The reader shouldappreciate that this lockout system serves as both a spent cartridgelockout and as a missing cartridge lockout. The entire disclosure ofU.S. Pat. No. 9,566,064, entitled SURGICAL STAPLING APPARATUS, whichissued on Feb. 14, 2017 is incorporated by reference herein.

Further to the above, the sled lock supports 10956 and 10958 are incontact with the cartridge lock supports 10916 and 10918 when the sled10950 is in its proximal unfired position. In such instances, thecartridge lock supports 10916 and 10918 releasably hold the sled 10950in its proximal unfired position until the sled 10950 is pushed distallyby the firing member 10990 owing to frictional resistance between thecartridge lock supports 10916 and 10918 and the sled lock supports 10956and 10958, respectively. Such an arrangement can prevent, or at leastinhibit, the sled 10950 from being moved distally accidentally prior tothe staple firing stroke.

In various embodiments, further to the above, the lock arms 10980 canalso serve as a closure lockout. More specifically, as discussed above,the firing member 10990 is advanceable distally to close the endeffector of the surgical instrument and then advanceable distally againto perform a staple firing stroke. If the firing member 10990 is notunlocked by the staple cartridge 10900 as discussed above, then the lockarms 10980 would be engaged with the firing member 10990 at the outsetof the closure stroke and, as a result, the firing member 10990 wouldnot be advanceable distally to close the end effector. In variousalternative embodiments, the lock windows 10996 defined in the firingmember 10990 are sized and configured to permit the firing member 10990to move distally far enough to close the end effector even if the lockarms 10980 have not been moved into their unlocked positions by anunfired staple cartridge 10900. In such embodiments, referring to FIGS.26B and 26C, the stapling instrument can further comprise a separateclosure lockout which prevents the end effector from closing if a staplecartridge is missing from the stapling instrument, as discussed furtherbelow.

In various embodiments, a surgical instrument can further comprise lockarms 10980′ which are rotatable between a locked position in which theyare engaged with a sidewall of a lock window 10986′ defined in a firingmember 10990′ and an unlocked position in which the lock arms 10980′ arenot engaged with the firing member 10990′. A staple cartridge 10900′,which is similar to the staple cartridge 10900 in many respects,comprises closure keys 10916′ extending from a cartridge body 10910′ ofthe staple cartridge 10900′ which can engage the lock arms 10986′ andmove the lock arms 10986′ into their unlocked position. In at least oneembodiment, the closure keys 10916′ of the staple cartridge 10900′unlock the lock arms 10986′ when the staple cartridge 10900′ is seatedin the surgical instrument. At such point, the firing member 10990′ isin an unlocked closure state and can be advanced distally to perform aclosure stroke to close the end effector. That said, whether or not thefiring member 10990′ is an unlocked firing state to then perform astaple firing stroke is determined by the position of the lock arms10980, as discussed above.

In various alternative embodiments, further to the above, the closurekeys 10916′ do not automatically unlock the lock arms 10980′ when thestaple cartridge 10900′ is seated in the surgical instrument. Instead,the closure keys 10916′ can engage the lock arms 10980′ when thecartridge jaw supporting the staple cartridge 10990′ is moved toward itsclosed, or clamped, position. In such embodiments, the lock window10996′ defined in the firing member 10990′ is sized and configured topermit some initial distal movement of the firing member 10990′ when theclosure stroke is initiated and, if the closure keys 10916′ engage andunlock the lock arms 10980′ during this initial movement, the firingmember 10990′ enters into its unlocked closure state and can be advanceddistally to complete the closure stroke. If, however, the staplecartridge seated in the cartridge jaw does not comprise the closure keys10916′, the lock arms 10980′ are not unlocked by the initial movement ofthe firing member 10990′ and the lock arms 10980′ will stop the firingmember 10990′ from completing the closure stroke. Such an arrangementcan prevent incompatible staple cartridges from being used with asurgical instrument.

The firing lockout discussed above in connection with FIGS. 26-26C keysoff of the presence of the sled 10950 being positioned in the proximalend of the staple cartridge 10900 when the staple firing stroke isinitiated. Another embodiment is illustrated in FIG. 29 which comprisesa staple cartridge 11900 for use with a stapling instrument comprising afiring lockout. The staple cartridge 11900 comprises a cartridge body,staple drivers, and staples removably stored in staple cavities definedin the cartridge body. The staple cartridge 11900 further comprises asled 11950 including a lock support 11958 that is moved from a proximalunfired position (FIG. 29 ) to a distal fired position (FIG. 30 ) by atissue cutting knife 11990 of the stapling instrument during a staplefiring stroke. The staple cartridge 11900 further comprises a pan 11960attached to the cartridge body which prevents the staple drivers and/orstaples from falling out of the bottom of the cartridge body. The pan11960 comprises a lock support 11968 which sits on top of the locksupport 11958 of the sled 11950 when the sled 11950 is in its proximalunfired position (FIG. 29 ). In such instances, the pan lock support11968 and the sled lock support 11958 co-operate to hold a lock arm11980 of the stapling instrument in an unlocked position against abiasing force being applied to the lock arm 11980 by a biasing spring11985 positioned intermediate the lock arm 11980 and a frame of thestapling instrument. In such instances, a lock end 11986 of the lock arm11980 is not positioned in a lock notch 11996 defined in the tissuecutting knife 11990 and, as a result, the tissue cutting knife 11990 canbe moved distally through the staple firing stroke. When the sled 11950is moved distally by the tissue cutting knife 11990, referring to FIG.30 , the sled lock support 11958 no longer supports the pan lock support11968 and, as a result, the biasing spring 11985 pushes the lock arm11980 downwardly which bends, or deflects, the pan lock support 11968downwardly. At such point, the lock notch 11996 is no longer alignedwith the lock end 11986 of the lock arm 11980 and, as a result, the lockend 11986 is pushed against the bottom of the tissue cutting knife 11990by the spring 11985 throughout the remainder of the staple firingstroke. When the tissue cutting knife 11990 is retracted, however, thelock notch 11996 is re-aligned with the lock end 11986 which is pushedinto the lock notch 11996 by the spring 11985. In such instances, thetissue cutting knife 11990 is locked from being advanced distallythrough another staple firing stroke without the spent staple cartridge11900 being replaced with an unspent staple cartridge 11900. The readershould appreciate that this lockout system serves as both a spentcartridge lockout and as a missing cartridge lockout.

A staple cartridge 12900 comprising a spent cartridge lockout isillustrated in FIGS. 31-31D. The staple cartridge 12900 comprises acartridge body including longitudinal rows of staple cavities, staplespositioned within the staple cavities, and a sled 12950 movable from aproximal unfired position (FIG. 31A) to a distal fired position (FIG.31B) to eject the staples from the staple cavities. The staple cartridge12900 is seatable in a cartridge jaw 12420 of a stapling instrument suchthat the sled 12950 is positioned in front of a tissue cutting knife12990 of the stapling instrument. When the sled 12950 is in its proximalunfired position, referring to FIG. 31A, the sled 12950 is held inposition between two springs 12980 extending from the cartridge bodypositioned on opposite sides of the sled 12950. Referring to FIG. 31 ,each spring 12980 comprises an apex 12982, a proximal side 12984 on theproximal side of the apex 12982, and a distal side 12986 on the distalside of the apex 12982. When the sled 12950 is in its proximal unfiredposition, as illustrated in FIG. 31A, the sled 12950 is wedged betweenthe apexes 12982 of the springs 12980 and compresses the springs 12980laterally. Stated another way, the sled 12950 holds open a largeropening between the springs 12980 such that the tissue cutting knife12990 can move between the springs 12980 to push the sled 12950 distallythrough the staple firing stroke, which is illustrated in FIG. 31B.During the staple firing stroke, the springs 12980 resiliently return totheir unflexed states to partially close the gap between the apexes12982 of the springs 12980 owing to the absence of the sled 12950positioned therebetween. After the staple firing stroke, referring toFIG. 31C, the tissue cutting knife 12990 is retracted proximally untilit contacts the distal sides 12986 of the springs 12980. The distalsides 12986 are angled, or sloped, such that the tissue cutting knife12990 can deflect the springs 12980 laterally as the tissue cuttingknife 12990 is retracted proximally until the tissue cutting knife 12990passes by the springs 12980. At such point, the springs 12980resiliently return to their unflexed configurations to partially closethe gap between the spring apexes 12988, as illustrated in FIG. 31D.Notably, the sled 12950 is not retracted proximally with the tissuecutting knife 12990 and, as such, the sled 12950 is not positioned toexpand the gap between the spring axes 12982 after the staple firingstroke. If the tissue cutting knife 12990 is advanced distally onceagain without replacing the now-spent staple cartridge 12900, the tissuecutting knife 12990 contacts the proximal sides 12984 of the springs12980 in their unflexed state and, owing to slope or angle of theproximal sides 12984, the tissue cutting knife 12990 is unable to passby the springs 12980. Such an arrangement, as a result, provides a spentcartridge lockout. When the spent staple cartridge is replaced with anunspent staple cartridge, the tissue cutting knife 12990 can be advanceddistally through another staple firing stroke.

As described above, referring again to FIG. 31 , the proximal sides12984 of the springs 12980 and the distal sides 12986 of the springs12980 extend at different angles. More specifically, the distal sides12986 extend at more shallow angles than the proximal sides 12984.Another way of describing this arraignment is that the distal sides12986 have a length L1 which is longer than the length L2 of theproximal sides 12984. In various embodiments, the springs 12980 arecomprised of metal, for example. In at least one such embodiment, thesprings 12980 are part of a metal pan extending under and attached tothe staple cartridge 12900. In another embodiment, the springs 12980comprise metal inserts in a plastic cartridge body of the staplecartridge 12900. In various other embodiments, the springs 12980 arecomprised of plastic and are integrally formed with a plastic cartridgebody of the staple cartridge 12900, for example.

An alternative spent cartridge lockout comprising springs 13980 isillustrated in FIG. 32 . The springs 13980 are connected to thecartridge body and/or the pan of the staple cartridge at a pivot 13981and, similar to the springs 12980, are held in a compressed state by thesled 12950 when the sled 12950 is in its proximal unfired position suchthat the tissue cutting knife 12990 can pass between the springs 13980to push the sled 12950 through its staple firing stroke. Each spring13980 comprises a proximal link 13984 and a distal link 13986 connectedat an apex 13982 of the spring 13980. The apex 13982 comprises a pivotjoint connecting the proximal link 13984 and the distal link 13986. Inat least one embodiment, the apex 13982 includes a score or notch in thebody of the spring 13980 which allows the links 13984 and 13986 to pivotrelative to one another. Each spring 13980 further comprises a base link13988 pivotably mounted to the proximal link 13984 at a pivot 13985.Similar to the above, the pivot 13985 can comprise a score or notch inthe body of the spring 13980, for example. Notably, the base link 13988comprises a free end which is unconnected to any other portion of thestaple cartridge that allows the base link 13988 to slide relative tothe cartridge body. When the tissue cutting knife 12990 is retractedafter the staple firing stroke, referring to FIG. 32 , the tissuecutting knife 12990 passes over the pivots 13981 and contacts the distallinks 13986. Owing to the free ends of the base links 13988, the springs13980 collapse to permit the tissue cutting knife 12990 to be retractedto its proximal unfired position. In such instances, the base links13988 slide proximally to accommodate this change in the configurationof the springs 13980. Once the tissue cutting knife 12990 is retractedpast the springs 13980, the springs 13980 resiliently return to theirunflexed shape. If the spent staple cartridge is not replaced and thetissue cutting knife 12990 is advanced distally once again, referring toFIG. 33 , the tissue cutting knife 12990 contacts the proximal links13984 of the springs 13980 and pushes the base links 13988 distallywhich, in turn, pushes the opposing apexes 13982 toward one another toclose the gap between the springs 13980 to prevent the tissue cuttingknife 12990 from being moved through the spent staple cartridge. Whenthe spent staple cartridge is replaced with an unspent staple cartridge,the tissue cutting knife 12990 can be advanced distally through anotherstaple firing stroke.

In various embodiments, as discussed above, a spent staple cartridge isreplaceable with an unspent staple cartridge. In certain embodiments,referring to FIG. 1 , a staple cartridge, such as staple cartridge 1900,for example, is snap-fit into the cartridge jaw 1420. In at least onesuch embodiment, the staple cartridge 1900 is positioned between theanvil jaw 1410 and the cartridge jaw 1420 with the pan of the staplecartridge 1900 facing toward the cartridge jaw 1420 and the deck of thestaple cartridge 1900 generally facing the anvil jaw 1410. With theproximal end of the staple cartridge 1900 being aligned with theproximal end of the cartridge jaw 1420 and the distal nose of the staplecartridge 1900 extending from the distal end of the cartridge jaw 1420,the clinician pushes down on the deck of the staple cartridge 1900 toseat the staple cartridge 1900 in the cartridge jaw 1420. In manyinstances, a considerable amount of force is needed to insert the staplecartridge 1900 into the cartridge jaw 1420. To remove the staplecartridge 1900 from the cartridge jaw 1420, an impact force is oftenapplied to the nose of the staple cartridge 1900 to dislodge the staplecartridge 1900 from its snap-fit arrangement with the cartridge jaw1420. Although this design is suitable for its intended purpose,improvements to this design are discussed below.

Referring to FIGS. 34-36 , a stapling instrument comprises a cartridgejaw 14420 configured to releasably receive a staple cartridge 14900therein. Similar to the cartridge jaw 1420, the cartridge jaw 14420comprises a bottom wall 14422 and opposing lateral sidewalls 14424extending upwardly from the bottom wall 14422. The walls 14422 and 14424are comprised of metal, such as stainless steel, for example, but couldbe comprised of any suitable metal. The staple cartridge 14900 isconfigured to be closely received between the lateral sidewalls 14420when the staple cartridge 14900 is seated in the cartridge jaw 14420such that there is no relative lateral movement between the staplecartridge 14900 and the cartridge jaw 14420. In various instances, thereis a line-to-line lateral fit between the staple cartridge 14900 and thecartridge jaw 14420 with little, if any, clearance therebetween. Thecartridge jaw 14420 further comprises alignment notches 14425 defined inthe lateral sidewalls 14424 which are configured to closely receivealignment projections 14905 extending from the staple cartridge 14900.The alignment notches 14425 and the alignment projections 14905 aresized and configured to co-operatively align the staple cartridge 14900longitudinally within the cartridge jaw 14420. Moreover, the alignmentnotches 14425 and the alignment projections 14905 are sized andconfigured such that there is no relative longitudinal movement betweenthe staple cartridge 14900 and the cartridge jaw 14420. In variousinstances, there is a line-to-line fit between the alignment notches14425 and the cartridge jaw 14420 with little, if any, clearancetherebetween. In various instances, further to the below, the fitbetween the staple cartridge 14900 and the cartridge jaw 14420 may be aslight friction fit and/or a zero-insertion-force (ZIF) fit.

Further to the above, the cartridge jaw 14420 further comprises acartridge lock, such as cartridge lock 14980, for example, which isconfigured to lock the staple cartridge 14900 into the cartridge jaw14420. The cartridge lock 14980 is slideable between an unlockedposition (FIG. 35 ) and a locked position (FIG. 36 ) to engage thecartridge lock 14980 with the staple cartridge 14900 after the staplecartridge 14900 has been positioned in the cartridge jaw 14420. Thecartridge lock 14980 comprises a base 14982 (FIGS. 37 and 38 ) slideablealong the base wall 14422 of the cartridge jaw 14420 and lock arms 14984extending distally therefrom. The cartridge lock 14980 is comprised ofstamped stainless steel, for example, but could be comprised of anysuitable material. When the cartridge lock 14980 is moved from itsunlocked position (FIG. 35 ) to its locked position (FIG. 36 ), the lockarms 14984 engage lock windows 14904 defined in the staple cartridge14900. In various embodiments, the cartridge lock 14980 furthercomprises a biasing spring configured to push the cartridge lock intoits locked position. In at least one embodiment, the lateral sidewalls14424 of the cartridge jaw 14420 comprise cam features which cam thelock arms 14984 into the lock windows 14904. In at least one embodiment,the lock arms 14984 are resiliently flexed outwardly when the staplecartridge 14900 is seated in the cartridge jaw 14420 and then relaxinwardly into the lock windows 14904 when the cartridge lock 14980 ismoved into its locked position. To unlock the staple cartridge 14900 andremove the staple cartridge 14900 from the cartridge jaw 14420, thecartridge lock 14980 is pulled proximally into its unlocked position todisengage the cartridge lock 14980 from the staple cartridge 14900. Suchan arrangement can avoid the need to apply an impact force to the staplecartridge 14900 to remove the staple cartridge 14900 from the cartridgejaw 14420.

As discussed herein, a firing member, such as a tissue cutting knife,for example, is movable distally to close an end effector of a staplinginstrument and then movable distally once again to perform a staplefiring stroke. Referring to FIGS. 27 and 28 once again, the firingmember 10990 comprises a first cam 10991 configured to engage acartridge jaw, such as cartridge jaw 1420, for example, and a second cam10992 configured to engage an anvil jaw, such as anvil jaw 1410, forexample. When the firing member 10990 is advanced distally from anunactuated position, the firing member 10990 contacts the anvil jaw 1410and the cartridge jaw 1420 to close the end effector 1400. In suchinstances, the cams 10991 and 10992 co-operatively work together duringa closure stroke to move the cartridge jaw 1420 from an open, unclampedposition to a closed, clamped position. To re-open the end effector1400, the firing member 10990 is retracted proximally to disengage thecam 10991 from the cartridge jaw 1420 so that the cartridge jaw 1420 canbe re-opened. Once the end effector 1400 is closed and the clinician issatisfied with the position of the end effector 1400 on the patienttissue, the firing member 10990 is moved distally once again to performthe staple firing stroke. Notably, the cams 10991 and 10992 co-operateto the hold the cartridge jaw 1420 in position relative to the anvil jaw1410 during the staple firing stroke. Also, notably, various embodimentsare envisioned in which the anvil jaw 1410 rotates relative to thecartridge jaw 1420 between an open position and a closed position andthe above-described arrangement is applicable to such embodiments.

A stapling instrument 15000 is illustrated in FIGS. 39-41 and is similarto stapling instruments 1000 and 2000 and/or other stapling instrumentsdisclosed herein in many respects, most of which will not be discussedherein for the sake of brevity. Referring to FIG. 29 , the staplinginstrument 15000 comprises a shaft 15200, an end effector 15400, and astaple cartridge 15900 positioned in the end effector 15400. The staplecartridge 15900 comprises a cartridge body 15910 including staplecavities, staples removably stored in the staple cavities, stapledrivers, and a sled 15950 movable from a proximal unfired position (FIG.39 ) to a distal fired position (FIG. 41 ) during a staple firingstroke. The end effector 15400 comprises a cartridge jaw 15420 and ananvil jaw 15410 rotatable relative to the cartridge jaw 15420 about ajaw pivot 15405 between an open, unclamped position and a closed,clamped position. The stapling instrument 15000 further comprises afiring drive including a tissue cutting knife 15990 which is movabledistally during a closure stroke to close the end effector 15400 andthen movable distally once again during the staple firing stroke to pushthe sled 15950 distally and eject the staples from the staple cavities.The tissue cutting knife 15990 comprises a cartridge cam 15991, an anvilcam 15993, and a tissue cutting edge 15995 positioned intermediate thecartridge cam 15991 and the anvil cam 15993, and is discussed in greaterdetail below.

The stapling instrument 15000 further comprises a tissue compressionlever 15800 which is engaged by the tissue cutting knife 15990 duringthe closure stroke to close the anvil jaw 15410. The tissue compressionlever 15800 is rotatably mounted to a frame of the shaft 15200 about apivot 15801 and comprises a distal end 15803 which extends distallyrelative to the pivot 15801 and a proximal end 15805 which extendsproximally relative to the pivot 15801. When the anvil jaw 15410 is inits open position, the tissue cutting knife 15990 is not engaged withthe tissue compression lever 15800. When the tissue cutting knife 15990is advanced distally during the closure stroke, referring to FIG. 39 ,the anvil cam 15993 of the tissue cutting knife 15990 contacts thedistal end 15803 of the tissue compression lever 15800 and rotates thedistal end 15803 downwardly. This rotation of the tissue compressionlever 15800 causes the proximal end 15805 of the tissue compressionlever 15800 to rotate upwardly. A spring 15810 is positionedintermediate the anvil jaw 15410 and the proximal end 15805 of thetissue compression lever 15800 at location which is proximal to the jawpivot 15405. Another spring 15290 pushes the tissue cutting knife 15990downwardly to hold the tissue cutting knife 15990 in contact with thecompression lever 15800. As a result of the above, the distal movementof the tissue cutting knife 15990 rotates the tissue compression lever15800 in a direction which, not only pushes the anvil jaw 15410 closedas illustrated in FIG. 39 , but pushes the anvil jaw 15410 into anover-compressed orientation as illustrated in FIG. 40 . Suchover-compression of the tissue occurs before the staple firing strokeand advantageously pushes some of the fluid contained in the tissueclamped between the jaws 15410 and 15420 into the adjacent tissue. Inmany instances, the clinician may pause for about 10 seconds, forexample after the closure stroke before performing the staple firingstroke to permit more fluid to flow out of the tissue. As a result ofthe above, the tissue may be thinner when it is stapled and/or thedeformation of the staples against the anvil 15410 may be moreconsistent.

Further to the above, the anvil jaw 15410 comprises a longitudinal slot15411 defined therein which is configured to receive the anvil cam 15993of the tissue cutting knife 15990 during the staple firing stroke. Thelongitudinal slot 15411 comprises a proximal ramp 15413 positionedadjacent to the distal end 15803 of the tissue compression lever 15800when the anvil jaw 15410 is in a closed position after the closurestroke. At the outset of the staple firing stroke, the tissue cuttingknife 15990 moves distally such that the anvil cam 15993 of the tissuecutting knife 15990 disengages from the tissue compression lever 15800and contacts the proximal ramp 15413 of the longitudinal slot 15411. Atsuch point, the pre-compression provided by the tissue compression lever15800 is relieved and the compression of the tissue during the staplefiring stroke is controlled by the anvil cam 15993 which slides alongthe bottom surface of the slot 15411 and the cartridge cam 15991 whichslides along the bottom surface of the anvil jaw 15420. In suchinstances, the cams 15991 and 15993 co-operatively control the positionof the anvil jaw 15410 relative to the staple cartridge 15900 and, also,co-operatively control the staple forming gap between the formingpockets in the anvil jaw 15410 and the drivers in the staple cartridge15900 as the drivers are lifted toward the anvil jaw 15410 during thestaple firing stroke. The tissue cutting knife 15990 also comprises alateral flange 15992 which extends into a longitudinal slot 15421defined in the cartridge jaw 15420 which can also assist in controllingthe relative positioning of the anvil jaw 15410 and the cartridge jaw15420. When the tissue cutting knife 15990 is retracted after the staplefiring stroke, referring to FIG. 41 , the anvil cam 15993 of the tissuecutting knife 15990 exits the longitudinal slot 15411, contacts thetissue compression lever 15880, and then disengages from the tissuecompression lever 15880 as the tissue cutting knife 15990 is reset intoits proximal unactuated position. At such point, the anvil jaw 15410 ispushed open by one or more jaw opening springs 15401 (FIG. 41 )positioned intermediate the anvil jaw 15410 and the cartridge jaw 15420that were resiliently compressed during the closure stroke.

The entire disclosures of U.S. Pat. No. 7,143,923, entitled SURGICALSTAPLING INSTRUMENT HAVING A FIRING LOCKOUT FOR AN UNCLOSED ANVIL, whichissued on Dec. 5, 2006; U.S. Pat. No. 7,044,352, SURGICAL STAPLINGINSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING,which issued on May 16, 2006; U.S. Pat. No. 7,000,818, SURGICAL STAPLINGINSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, whichissued on Feb. 21, 2006; U.S. Pat. No. 6,988,649, SURGICAL STAPLINGINSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT, which issued on Jan. 24,2006; and U.S. Pat. No. 6,978,921, SURGICAL STAPLING INSTRUMENTINCORPORATING AN E-BEAM FIRING MECHANISM, which issued on Dec. 27, 2005,are incorporated by reference herein.

Further to the above, referring now to FIGS. 42 and 43 , a staplinginstrument 16000 comprises a cartridge jaw 16420 and an anvil jaw 16410rotatable relative to the cartridge jaw 16420. The stapling instrument16000 further comprises a tissue cutting knife 16990 movable distallyfrom a proximal unfired position (FIG. 42 ) to a distal position (FIG.43 ) to perform a closure stroke and then a distal fired position toperform a staple firing stroke. The stapling instrument 16000 alsocomprises a tissue compression lever 16800 which, similar to the tissuecompression lever 15800, is contacted by the tissue cutting knife 16990to close the anvil jaw 16410 and apply a compression force to the tissuecaptured between the anvil jaw 16410 and the staple cartridge seated inthe cartridge jaw 16420. Also similar to the tissue compression lever15800, the tissue compression lever 16800 is rotatably coupled to theshaft of the stapling instrument 16000 about a pivot 16801 and comprisesa distal end 16803 and a proximal end 16805. The tissue cutting knife16990 comprises an anvil cam 16993 and, at the outset of the closurestroke, referring to FIG. 43 , the anvil cam 16993 contacts the distalend 16803 of the tissue compression lever 16800 to rotate the tissuecompression lever 16800 and apply a closing force to the anvil jaw 16993via a compression spring 16810. Notably, as illustrated in FIG. 43 , theanvil cam 16993 has moved distally off of the tissue compression lever16800 by the end of the closure stroke and does not hold the tissuecompression lever 16800 in its rotated position. Instead, as alsoillustrated in FIG. 43 , the distal advancement of the tissue cuttingknife 16990 to perform the closure stroke releases a spring-loadedclosure latch 16820 which engages the tissue compression lever 16800 andholds the tissue compression lever 16800 in its rotated position and, asa result, holds the anvil jaw 16410 in its closed position. The latch16820 is rotatably mounted to the frame of the stapling instrument 16000and is held in an unlocked position (FIG. 42 ) by a lateral shoulder16992 extending from the tissue cutting knife 16990 when the tissuecutting knife 16990 is in its proximal unactuated position. During theclose stroke, the lateral shoulder 16992 disengages from the latch 16820which, owing to a spring force applied to the latch 16820 by a torsionspring, for example, the latch 16820 rotates into a locked position(FIG. 42 ) in which a lock 16822 extending from the latch 16820 engagesa lock shoulder 16802 defined in the tissue compression lever 16800. Atsuch point, the latch 16820 is able to hold the anvil jaw 16410 in itsclosed position while the anvil cam 16993 of the tissue cutting knife16900 transfers off of the tissue compression lever 16800 onto a ramp16413 of a longitudinal slot 16411 defined in the anvil jaw 16410.Notably, the latch 16820 holds the tissue compression lever 16800 in aposition which is distal to the jaw pivot connecting the anvil jaw 16410and the cartridge jaw 16420.

Further to the above, the tissue cutting knife 16990 further comprises acartridge cam 16991 that enters into a longitudinal slot 16421 definedin the cartridge jaw 16420 during the closure stroke of the tissuecutting knife 16990. As the tissue cutting knife 16990 is advanceddistally through a staple firing stroke, the anvil cam 16993 and thecartridge cam 16991 co-operate to hold the anvil jaw 16410 in its closedposition. That said, the latch 16820 also holds the anvil jaw 16410 inits closed position and provides a second jaw holding mechanism. Whenthe tissue cutting knife 16990 is retracted proximally after the staplefiring stroke, the lateral shoulder 16992 extending from the tissuecutting knife 16990 contacts the latch 16820 and pushes the latch 16820back into its unlocked position (FIG. 42 ). At such point, the anvil jaw16410 is no longer locked in position by the latch 16820 and/or theanvil cam 16993 and, as a result, the anvil jaw 16410 can be re-opened.

Further to the above, the shape and configuration of the longitudinalslot 16421 defined in the cartridge jaw 16420 is constant, or at leastsubstantially constant, along the length thereof. Similarly, the shapeand configuration of the longitudinal slot 16411 defined in the anviljaw 16410 is constant, or at least substantially constant, along thelength thereof. In this embodiment, the anvil cam 16991 and thecartridge cam 16992 co-operate to hold the anvil jaw 16410 at a fixed,or an at least substantially fixed, distance relative to the cartridgejaw 16420 during the staple firing stroke.

A stapling instrument 17000 is illustrated in FIG. 44 and is similar tothe stapling instruments 1000 and 2000 and other stapling instrumentsdisclosed herein in many respects, most of which will not be discussedherein out of the sake of brevity. The stapling instrument 17000comprises an end effector 17400 including a cartridge jaw 17420 and ananvil jaw 17410, a staple cartridge 15900, for example, positioned inthe cartridge jaw 17420, and a firing drive including a tissue cuttingknife 15990. The cartridge jaw 17420 is pivotably coupled to the anviljaw 17410 and is movable relative to the anvil jaw 17410 from an openposition to a closed position during the closure stroke of the tissuecutting knife 15990. The anvil jaw 17410 comprises a longitudinal slot17411 defined therein which is configured to receive an anvil cam 15993of the tissue cutting knife 15990 during the staple firing stroke of thetissue cutting knife 15990. The anvil longitudinal slot 17411 comprisesa proximal end 17413 and a distal end 17415 and a cam surface 17419extending between the proximal end 17413 and the distal end 17415. Whenthe tissue cutting knife 15990 is advanced distally through the staplefiring stroke, the anvil cam 15993 slides along the cam surface 17419 ofthe anvil jaw 17410. Similar to the above, the cartridge jaw 17420comprises a longitudinal slot 17421 defined therein which is configuredto receive a cartridge cam 15991 of the tissue cutting knife 15990during the staple firing stroke. The cartridge longitudinal slot 17421comprises a proximal end 17423 and a distal end 17425 and a cam surface17429 extending between the proximal end 17423 and the distal end 17425.When the tissue cutting knife 15990 is advanced distally through thestaple firing stroke, the cartridge cam 15991 slides along the camsurface 17429 of the cartridge jaw 17420. In various instances, thetissue compressed between the anvil jaw 17410 and the staple cartridge15900 provides a resilient spring force to the anvil jaw 17410 and thestaple cartridge 15900 which acts to push the jaws 17410 and 17420 awayfrom one another. Owing to the cams 15991 and 15993 of the tissuecutting knife 15990, however, the relative position of the jaws 17410and 17420 is constrained by the tissue cutting knife 15990.

Further to the above, referring to FIGS. 44-44B, the cartridge jaw 17420comprises a bottom wall 17422 configured to support the staple cartridge15900 and lateral sidewalls 17424 extending upwardly from the bottomwall 17422 which are sized and configured to closely receive the staplecartridge 15900 therebetween. The staple cartridge 15900 furthercomprises a tissue supporting deck 15913 which faces the anvil jaw 17410when the cartridge jaw 17420 is in its closed, or clamped, position, asillustrated in FIGS. 44-44B. The anvil jaw 17410 comprises a tissuesupporting portion 17412 which is positioned opposite the deck 15913 ofthe staple cartridge 15900 and comprises longitudinal rows of stapleforming pockets defined therein configured to deform the staples ejectedfrom the staple cartridge 15900 during the staple firing stroke.Notably, referring primarily to FIG. 44 , the tissue supporting portion17412 also defines the longitudinal cam surface 17419 and comprises aconstant thickness, or an at least substantially constant thickness,along the longitudinal length thereof. Also, notably, the bottom wall17422 of the cartridge jaw 17420 defines the longitudinal cam surface17429 and comprises a thickness that is not constant along thelongitudinal length thereof. Rather, the thickness of the bottom wall17422 is thinner at the proximal end 17423 and thicker at the distal end17425. The thickness of the bottom wall 17422 tapers linearly, or atleast substantially linearly, between the proximal end 17423 and thedistal end 17425. That said, the thickness of the bottom wall 17422 cantaper in any suitable manner. Owing to this arrangement, the distancebetween the anvil jaw cam surface 17419 and the cartridge jaw camsurface 17429 would change along the longitudinal length of the endeffector 17400 for a given position of the cartridge jaw 17420. In manyinstances, however, the cartridge jaw 17420 moves relative to the anviljaw 17410 during the staple firing stroke owing to the compressed tissuepositioned between the staple cartridge 15900 and the anvil jaw 17410.During the staple firing stroke, the sloped longitudinal cam surface17429 of the cartridge jaw 17420 causes the tissue cutting knife 15990to draw the cartridge jaw 15420 toward the anvil jaw 15410 and narrowthe gap, i.e., the tissue gap, between the staple cartridge 15900 andthe anvil jaw 15410. This movement of the cartridge jaw 17420 can bereadily noticed when comparing FIG. 44A, which depicts the beginning ofthe staple firing stroke, and FIG. 44B, which depicts the end of thestaple firing stroke. As can be seen in FIGS. 44A and 44B, the tissuegap g_(p) closes significantly. Such an arrangement applies a largerclamping force and/or clamping pressure to the tissue at the distal endof the end effector 15400 as the staple firing stroke progresses whichcan inhibit the tissue from being pushed out the distal end of the endeffector 15400. Moreover, such an arrangement can compensate forsituations where the anvil jaw 17410 flexes away from the cartridge jaw17420 during the staple firing stroke.

Further to the above, referring again to FIGS. 44-44B, the height of theanvil longitudinal slot 17411 narrows along the length thereof. Thatsaid, the height of the cartridge longitudinal slot 17421 also narrowsalong the length thereof but the thickness of the cartridge support17422 increases along the length thereof. Various other embodiments areenvisioned in which the thickness of the cartridge support 17422increases along the longitudinal length thereof but the height of thelongitudinal slot 17421 does not change, or at least substantiallychange. Whether or not the longitudinal slots 17411 and 17421 aretapered, various embodiments are envisioned in which one or both of thelongitudinal slots 17411 and 17421 comprise enlarged proximal openingsso that they can reliably receive the tissue cutting member cams 15993and 15991, respectively. In various instances, the anvil jaw cam 15993is longitudinally longer than the cartridge jaw cam 15991. Such anarrangement can reliably hold the tissue cutting edge 15995 in alignmentwith the tissue captured between the staple cartridge 15900 and theanvil jaw 17410. In embodiments where the anvil jaw 17410 is rotatableand the cartridge jaw 17420 does not rotate, the cartridge jaw cam 15991can be longer than the anvil jaw cam 15993 to achieve the same result.That said, the cams 15991 and 15993 can comprise any suitable lengthand/or configuration. The entire disclosure of U.S. Pat. No. 9,844,369,entitled SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORINGARRANGEMENTS, which issued on Dec. 19, 2017 is incorporated by referenceherein.

Referring again to FIGS. 44A and 44B, the cartridge jaw 17420 defines aclosed-bottom channel. In at least one embodiment, the bottom of thecartridge channel below the tissue cutting knife 15990 is entirelyclosed along the entire bottom of the cartridge jaw 17420. In suchinstances, the cartridge jaw 17420 is quite stiff and does not bend, orat least substantially bend, during the staple firing stroke. In atleast one such embodiment, the bottom of the cartridge channel can beconsidered closed even though viewing windows are defined in thecartridge channel which can be used by a clinician to observe theposition of the tissue cutting knife 15990. In other embodiments, thebottom of the cartridge channel is open, i.e., a longitudinal slot isdefined therein which opens to the bottom of the cartridge jaw 17420such that a portion of the tissue cutting knife 15990 is positionedoutside of the cartridge jaw 17420. The reader should appreciate that anopen cartridge channel may not be as stiff as a closed cartridgechannel. In at least one embodiment, a portion of the sled extends downinto the longitudinal slot of an open cartridge channel so as to stiffenthe cartridge jaw 17420. The entire disclosure of U.S. PatentApplication Publication No. 2015/0297228, entitled FASTENER CARTRIDGESINCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS, which published onOct. 22, 2015 is incorporated by reference herein.

As discussed above, a staple cartridge can be configured to fire threelongitudinal rows of staples on each side of an incision made in patienttissue during a staple firing stroke. In various instances, the staplecartridge, and the stapling instrument used to fire the staples from thestaple cartridge, is configured to deform all of the staples to thesame, or at least substantially the same, deformed height. In otherinstances, the staple cartridge and the stapling instrument areconfigured to deform the staples to different formed heights. In atleast one such instance, the staple cartridge and the staplinginstrument are configured to fire six longitudinal rows of staples—threerows on each side of the incision—such that the innermost two rows ofstaples are deformed to a first height, the intermediate rows of staplesadjacent the innermost two rows are deformed to a second height that islarger than the first deformed height, and the outermost rows of staplesare deformed to a third height that is larger than the second deformedheight. Such different deformed heights can be created in a number ofdifferent ways. For instance, the staple forming pockets in the anvil ofthe stapling instrument can be shallower in the innermost rows offorming pockets and deeper in the intermediate rows of forming pockets.Similarly, the staple forming pockets in the anvil can be deeper in theoutermost rows of forming pockets than the intermediate rows of formingpockets. Also, for instance, the staple drivers that drive the innermostrows of staples can lift the innermost staples closer to the anvil thanthe intermediate staple drivers. Similarly, the staple drivers thatdrive the intermediate rows of staples can lift the intermediate staplescloser to the anvil than the outermost staple drivers. In at least onesuch embodiment, the innermost staple drivers, the intermediate stapledrivers, and the outermost staple drivers are unconnected to oneanother. In other embodiments, some of the staple drivers are connectedto one another. In at least one such embodiment, an innermost stapledriver, an intermediate staple driver, and an outermost staple driverare connected to one another such that they are lifted together by thecartridge sled. The entire disclosures of U.S. Pat. No. 8,317,070,entitled SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS, which issued on Nov. 27, 2012, InternationalPublication No. WO2003/094747, entitled SURGICAL STAPLER AND DISPOSABLELOADING UNIT HAVING DIFFERENT SIZE STAPLES, and U.S. Patent ApplicationPublication No. 2010/0243707, entitled SURGICAL STAPLING APPARATUS,which published on Sep. 30, 2010 are incorporated by reference herein.

Regardless of how the staples are deformed into different deformedheights during the staple firing stroke, further to the above, theinnermost staples—which are deformed to a shorter deformed height thanthe intermediate staples—can apply a larger clamping pressure to thepatient tissue than the intermediate staples. Similarly, theintermediate staples—which are deformed to a shorter deformed heightthan the outermost staples—can apply a larger clamping pressure to thepatient tissue than the outermost staples. As a result of the above, theinnermost staples and the intermediate staples can seal, or at leastsubstantially seal, the incised margin of the patient tissue while thelarger outermost staples can support the patient tissue while affordingsome flexibility to the tissue captured within the staples. As discussedabove, the innermost staples are deformed to a first deformed height,the intermediate staples are deformed to a second deformed height thatis taller than the first deformed height, and the outermost staples aredeformed to a third deformed height that is taller than the seconddeformed height. These first, second, and third deformed heights are setduring the staple firing stroke, but it should be understood that thesedeformed heights may increase, or grow, slightly after the stapledtissue is released from between the jaws of the stapling instrument.This phenomenon can be referred to as “spring back” and is the result ofthe internal pressure created within the captured tissue and theresiliency of the metal staples, among other things. That said, evenafter the spring back has increased the deformed heights of theinnermost staples, the intermediate staples, and the outermost staples,the deformed innermost staples are still shorter than the deformedintermediate staples and, likewise, the deformed intermediate staplesare shorter than the deformed outermost staples. For easy reference, thedeformed height of the staples immediately after they are deformed canbe called the “as-formed height” and the deformed height of the staplesafter they have relaxed—owing to spring back—can be called the“post-formed height”.

Further to the above, a staple cartridge 19900 is illustrated in FIG. 46and is similar to the staple cartridge 1900 and other staple cartridgesdisclosed herein in many respects, most of which are not discussedherein for the sake of brevity. The staple cartridge 19900 comprises acartridge body 19910 including a deck 19913 configured to supportpatient tissue, a longitudinal slot 19914 configured to receive a tissuecutting knife, and longitudinal rows of staple cavities 19920 a, 19920b, and 19920 c defined in the deck 19913 on each side of thelongitudinal slot 19914. The longitudinal rows of staple cavities 19920a adjacent the longitudinal slot 19914 comprise the innermost staplecavities, the longitudinal rows of staple cavities 19920 b compriseintermediate staple cavities, and the longitudinal rows of staplecavities 19920 c comprise the outermost staple cavities. The staplecartridge 19900 further comprises first staples 19970 a removablypositioned in the innermost staple cavities 19920 a, second staples19970 b removably positioned in the intermediate staple cavities 19920b, and third staples 19970 c removably positioned in the outermoststaple cavities 19920 c. In at least one embodiment, the first staples19970 a have a first unformed height, the second staples 19970 b have asecond unformed height, and the third staples 19970 c have a thirdunformed height where the first unformed height, the second unformedheight, and third unformed height are the same. The reader shouldappreciate that the staples 19970 a, 19970 b, and 19970 c have the sameunformed height despite variations to the unformed heights owing tomanufacturing tolerances. For instance, in at least one embodiment, thestaples 19970 a, 19970 b, and 19970 c have the same unformed height whentheir unformed heights fall between 3.8 mm and 4.2 mm, for example. Inanother embodiment, the staples 19970 a, 19970 b, and 19970 c have thesame unformed height when their unformed heights fall between 1.9 mm and2.1 mm, for example. In various alternative embodiments, the firstunformed height is shorter than the second unformed height, and thesecond unformed height is shorter than the third unformed height. In atleast one such embodiment, the first unformed height is about 2.0 mm,the second unformed height is about 3.0 mm, and the third unformedheight is about 4.0 mm, for example.

Further to the above, FIG. 46A depicts the progression of the firststaples 19970 a, the second staples 19970 b, and the third staples 19970c from their unformed heights to their as-formed heights and then totheir post-formed heights. Notably, the staple cartridge 19900 is usablewith a stapling instrument which is configured to co-operatively deformthe first staples 19970 a, the second staples 19970 b, and the thirdstaples 19970 c to the same formed height. The reader should appreciatethat, owing to manufacturing tolerances and/or variances in tissuethickness and density, that the staples 19970 a, 19970 b, and 19970 cwill not all be deformed to the exact same height. Rather, the staples19970 a, 19970 b, and 19970 c are deformed to the same formed heightwhen their formed heights fall within the same range of heights. Forinstance, the staples 19970 a, 19970 b, and 19970 c are deformed to thesame formed height when their formed heights are within a range of 1.90mm-2.10 mm, for example. In other instances, the staples 19970 a, 19970b, and 19970 c are deformed to the same formed height when their formedheights are within a range of 1.35 mm-1.65 mm, for example. That said,any suitable formed height, or formed height range, can be used.

Notably, referring again to FIG. 46A, the first staples 19970 a do notrelax much, if at all, between their as-formed height and theirpost-formed height. That said, the second staples 19970 b relax a largeramount between their as-formed height and their post-formed height thanthe first staples 19970 a. Moreover, the third staples 19970 c relax alarger amount between their as-formed height and their post-formedheight than the second staples 19970 b. Stated another way, the firststaples 19970 a, the second staples 19970 b, and the third staples 19970c relax to different post-formed heights even though their as-formedheights are the same. In various instances, these different post-formedheights occur owing to the softness, or compliance, of the metal used tomake the first staples 19970 a, the second staples 19970 b, and thethird staples 19970 c. In at least one such instance, the second staples19970 b have less annealing than the first staples 19970 a, and thethird staples 19970 c have less annealing than the second staples 19970b, for example, thereby making the third staples 19970 c softer than thesecond staples 19970 b and the second staples 19970 b softer than thefirst staples 19970 a.

Further to the above, various embodiments are envisioned in which thefirst staples 19970 a, 19970 b, and 19970 c have the same as-formedheights but different post-formed heights regardless of whether thestaples 19970 a, 19970 b, and 19970 c have the same unformed height ordifferent unformed heights. In various embodiments, the staples 19970 a,19970 b, and 19970 c are comprised of stainless steel, titanium, and/orNitinol—an alloy of nickel and titanium, for example. That said,embodiments are envisioned in which the first staples 19970 a arecomprised of a first material, the second staples 19970 b are comprisedof a second material, and third staples 19970 c are comprised of a thirdmaterial such that the first staples 19970 a, the second staples 19970b, and the third staples 19970 c can relax from the same as-formedheights to different post-formed heights. In at least one embodiment,the first staples 19970 a are comprised of a material having a firstmodulus of elasticity, the second staples 19970 b are comprised of amaterial have a second modulus of elasticity which is lower than thefirst modulus of elasticity, and the third staples 19970 c are comprisedof a material having a third modulus of elasticity which is lower thanthe second modulus of elasticity. In at least one embodiment, the firststaples 19970 a are comprised of a material having a first stiffness,the second staples 19970 b are comprised of a material have a secondstiffness which is lower than the first stiffness, and the third staples19970 c are comprised of a material having a third stiffness which islower than the second stiffness.

In various alternative embodiments, referring now to FIG. 46B, thestaple cartridge 19900 can comprise first staples 29970 a, secondstaples 29970 b, and staples 29970 c having the same unformed shape.Notably, the first staples 29970 a, second staples 29970 b, and thirdstaples 29970 c have different as-formed shapes. In their as-formedshapes, the radius between the base of the first staples 29970 a and thelegs of the first staples 29970 a have a first radius, the radiusbetween the base of the second staples 29970 b and the legs of thesecond staples 29970 b have a second radius which is smaller than thefirst radius, and the radius between the base of the third staples 29970c and the legs of the third staples 29970 c have a third radius which issmaller than the second radius. Owing to the radii of the as-formedstaple shapes and the materials of the staples 29970 a, 29970 b, and29970 c, the third staples 29970 c have more spring back than the secondstaples 29970 b, and the second staples 29970 b have more spring backthan the first staples 29970 a which result in different post-formedshapes for the staples 29970 a, 29970 b, and 29970 c. In variousinstances, the first staple forming pockets, the second forming pockets,and the third forming pockets of the anvil comprise differentconfigurations which can produce the different as-formed shapes of thestaples 29970 a, 29970 b, and 29970 c. In at least one embodiment, theratio of the entry radius to the exit radius of a staple forming pocketdetermines the as-formed shape of a staple. For instance, when the entryradius and the exit radius of a forming pocket are about the same, i.e.1:1, the forming pocket deforms the staple to a large continuous radius.In at least one embodiment, staples that are deformed into a largecontinuous radius have little, if any, spring back. Such forming pocketscan be suitable to deform an inner row of staples, for example. When theentry radius and the exit radius have a ratio of about 3:1, the deformedstaples have a sharper radius and a larger spring back. Such formingpockets can be suitable to deform an outer row of staples, for example.

An end effector 21400 of a stapling instrument is illustrated in FIG. 48and is similar to the other end effectors disclosed herein in manyrespects, many of which will not be discussed herein for the sake ofbrevity. The end effector 21400 comprises an anvil jaw 21410, acartridge jaw 21420, and a staple cartridge 21900 positioned in thecartridge jaw 21420. The anvil jaw 21410 comprises a cap, or cover,21411 and tissue support plates 21412 welded to the cap 21411. Eachsupport plate 21412 comprises a longitudinal lateral flange 21417extending therefrom which is positioned in a longitudinal slot, orrolled gutter, 21415 defined in a folded lateral lip of the cap 21411.In various instances, the longitudinal lateral flanges 21417 arepress-fit into their respective longitudinal slots 21415 and then weldedinto place. In at least one instance, openings, or apertures, aredefined in the cap 21411 which allow the lateral flanges 21417 to bedirectly welded to the cap 21411 so that the support plates 21412 areheld securely in position relative to the cap 21411. The support plates21412 are positioned and arranged such that a longitudinal slot 21414 isdefined between the support plates 21412 and such that a longitudinalcavity 21416 is defined between the support plates 21412 and the cap21411. The longitudinal slot 21414 and the longitudinal cavity 21416 aresized and configured to receive a tissue cutting knife therein. Eachsupport plate 21412 comprises a longitudinal row of first, or innermost,staple forming pockets 21413 a defined therein, a longitudinal row ofsecond, or intermediate, staple forming pockets 21413 b defined therein,and a longitudinal row of third, or outermost, staple forming pockets21413 c defined therein.

Further to the above, the staple cartridge 21900 comprises a cartridgebody 21900 including a deck configured to support patient tissue, alongitudinal slot 21914 at least partially extending between first andsecond sides of the deck, and longitudinal rows of staple cavities 21920a, 21920 b, and 21920 c defined therein which are registered with thestaple forming pockets 21413 a, 21413 b, and 21413 c, respectively. Eachside of the deck comprises a first, or inner, longitudinal step 21913 aadjacent the longitudinal slot 21914, a second, or intermediate,longitudinal step 21913 b extending alongside the first longitudinalstep 21913 a, and a third, or outer, longitudinal step 21913 c extendingalongside the second longitudinal step 21913 b. Notably, the innerlongitudinal step 21913 a is closer to the anvil jaw 21410 than thelongitudinal steps 21913 b and 21913 c and, owing to its height, thelongitudinal step 21913 a applies a larger clamping pressure to thepatient tissue captured between the staple cartridge 21900 and the anviljaw 21410 than the longitudinal steps 21913 b and 21913 c. Similarly,the intermediate longitudinal step 21913 b is closer to the anvil jaw21410 than the longitudinal step 21913 c and, owing to its height, thelongitudinal step 21913 b applies a larger clamping pressure to thepatient tissue captured between the staple cartridge 21900 and the anviljaw 21410 than the longitudinal step 21913 c. Such an arrangement canhold the patient tissue tightly alongside the longitudinal slot 21914such that the tissue cutting knife passing through the longitudinal slot21914 does not push and/or disorient the patient tissue during thestaple firing stroke. Such an arrangement also provides relief to thepatient tissue at the lateral edges of the end effector 21400 so thatthe patient tissue does not rip or tear.

Further to the above, the staple cartridge 21900 further comprises firststaples 21970 a positioned in the first staple cavities 21920 a, secondstaples 21970 b positioned in second staple cavities 21920 b, and thirdstaples 21970 c positioned in third staple cavities 21920 c. The firststaples 21970 a are comprised of wire having a first diameter, thesecond staples 21970 b are comprised of wire having a second diameterthat is smaller than the first diameter, and the third staples 21970 care comprised of wire having a third diameter than is smaller than thesecond diameter. During the staple firing stroke, the first staples21970 a are deformed against their respective anvil forming pockets21413 a, the second staples 21970 b are deformed against theirrespective anvil forming pockets 21413 b, and the third staples 21970 care deformed against their respective forming pockets 21413 c. In thisembodiment, the staples 21970 a, 21970 b, and 21970 c are all deformedto the same as-formed height, but spring back to different post-formedheights. More specifically, the first staples 21970 a have a firstpost-formed height, the second staples 21970 b have a second post-formedheight which is taller than the first post-formed height, and the thirdstaples 21970 c have a third post-formed height which is taller than thesecond post-formed height. This arrangement is represented in FIG. 49and can provide variable lateral compression within the tissue. As canbe seen in FIG. 49 , the staple cartridge 21900 comprises first stapledrivers 21960 a which fire the first staples 21970 a to the samedeformed height that the third staple drivers 21960 c fire the thirdstaples 21970 c. The forming height of the staples is determined by thedistance between the driver cradles 21961 a and 21961 c and the stapleforming pockets 21413 a and 21413 c, respectively. As can also be seenin FIG. 49 , each first staple 21970 a comprises a base 21971 a, legs21973 a extending from the base 21971 a, and radiused portions 21972 aconnecting the legs 21973 a to the base 21971 a. Similarly, each thirdstaple 21970 c comprises a base 21971 c, legs 21973 c extending from thebase 21971 c, and radiused portions 21972 c connecting the legs 21973 cto the base 21971 c. Notably, the radiused portions 21972 c are the samesize as the radiused portions 21972 a in their as-fired configurationsbut the radiused portions 21972 c are larger than the radiused portions21972 a after the staples reach their post-fired configurations.

As discussed above, a tissue cutting knife is advanced distally througha staple cartridge to eject the staples therefrom during a staple firingstroke. More specifically, in various embodiments, the tissue cuttingknife contacts a sled stored in the staple cartridge which is pusheddistally by the tissue cutting knife during the staple firing stroke.During the staple firing stroke, the sled contacts staple driverscontained within the staple cartridge which push, or fire, the staplesupwardly toward the an anvil positioned opposite the staple cartridge.Notably, the sled contacts and lifts the proximal-most staple driversfirst and then sequentially contacts and lifts the staple driverspositioned distally with respect to the proximal-most staple driversuntil the distal-most staple drivers are contacted and lifted by thesled. As the sled is moved distally, however, the sled disengages fromthe drivers that it has just lifted to their fired positions. Thus, thetime in which the sled is in contact with an individual staple drivermay be brief as the sled lifts the staple driver to its fired positionand then moves on. Thus, the staples spend very little time undercompression (TUC) during the staple firing stroke. Staples that spendvery little time under compression may undergo what can be described asa brief impact force that creates a large amount of plastic yieldingwithin the staples. On the other hand, staples that spend a lot of timeunder compression may receive less of an impact force spike therebyresulting in less plastic yielding within the staples. Staples thatundergo more plastic yielding tend to have less spring back than staplesthat undergo less plastic yielding. As discussed further below, the sledof a staple cartridge can be configured to create more plastic yieldingwithin certain staples, or less plastic yielding within other staples,to create a desired arrangement of post-formed staple heights.

In various embodiments, referring to FIGS. 45-45B, a sled, such as sled18950, for example, comprises a first ramp 18952 a which engages andlifts the first staple drivers 21960 a, second ramps 18952 b whichengage and lift the second staple drivers, and third ramps 18952 c whichengage and lift the third staple drivers 21960 c. At the top of eachramp 18952 a, 18952 b, and 18952 c is a forming plateau which definesthe fully-formed position of the staple drivers being lifted by theramps 18952 a, 18952 b, and 18952 c. More specifically, the sled 18950comprises a first forming plateau 18953 a aligned with the first ramp18952 a, a second forming plateau 18953 b aligned with each second ramp18952 b, and a third forming plateau 18953 c aligned with each thirdramp 18952 c. When the first staple driver 21960 a reaches the top ofthe first ramp 18952 a, for example, the first staple driver 21960 aslides along the first forming plateau 18953 a and then falls off theback of the sled 18950 as the sled 18950 is advanced distally throughits staple firing stroke. Similarly, the second staple drivers 21960 bslide along their respective second forming plateaus 18953 b and thenfall off the back of the sled 18950 as the sled 18950 is advanceddistally through its staple firing stroke. Likewise, the third stapledrivers 21960 c slide along their respective third forming plateaus18953 c and then fall off the back of the sled 18950 as the sled 18950is advanced distally through its staple firing stroke. Notably, thefirst forming plateau 18953 a is shorter than the second formingplateaus 18953 b and, as a result, the first staples may have moreplastic yielding and less spring back than the second staples.Similarly, the second forming plateaus 18953 b are shorter than thethird forming plateaus 18953 c and, as a result, the second staples mayhave more plastic yielding and less spring back than the third staples.

Controlling the time under compression, as discussed above, can be usedto allow staples which have been deformed to the same as-formed heightto have different post-formed heights. That said, the sled 18950 is alsoconfigured to deform the first staples, the second staples, and thethird staples to different as-formed heights. For instance, the firstforming plateau 18953 a is higher than the second forming plateaus 18953b which means that the sled 18950 can lift the first staples to a higherforming height than the second staples and, in various instances, makethe deformed first staples smaller than the deformed second staples.Similarly, the second forming plateaus 18953 b are higher than the thirdforming plateaus 18953 c which means that the sled 18950 can lift thesecond staples to a higher forming height than the third staples and, invarious instances, make the deformed second staples smaller than thedeformed third staples. In various instances, referring to FIG. 45B, thesled 18950 is comprised of an inner core and an outer layer surroundingthe inner core. In at least one instance, the inner core can becomprised of a first material selected for its ability to withstand highforces without substantially deflecting and the outer layer can becomprised of a second material selected for its lubriciousness to reducethe friction forces between the sled 18950 and the staple drivers, forexample.

An end effector 20400 is illustrated in FIG. 47 and is similar to theend effector 21400 and other end effectors disclosed herein in manyrespects, most of which will not be discussed herein for the sake ofbrevity. The end effector 20400 comprises an anvil jaw 20410, acartridge jaw, and a staple cartridge 20900 seated in the cartridge jaw.The staple cartridge 20900 comprises a cartridge body 20910 including alongitudinal slot 20914 at least partially extending between first andsecond sides of the deck, and longitudinal rows of staple cavities 20920a, 20920 b, and 20920 c defined therein. Each side of the deck comprisesa first, or inner, longitudinal step 20913 a adjacent the longitudinalslot 20914, a second, or intermediate, longitudinal step 20913 bextending alongside the first longitudinal step 20913 a, and a third, orouter, longitudinal step 20913 c extending alongside the secondlongitudinal step 20913 b. The staple cavities 20920 a comprise openingsdefined in the first longitudinal steps 20913 a, the staple cavities20920 b comprise openings defined in the second longitudinal steps 20913b, and the staple cavities 20920 c comprise openings defined in thethird longitudinal steps 20913 c. Notably, the inner longitudinal step20913 a is closer to the anvil jaw 20410 than the longitudinal steps20913 b and 20913 c and, owing to its height, the longitudinal step20913 a applies a larger clamping pressure to the patient tissuecaptured between the staple cartridge 20900 and the anvil jaw 20410 thanthe longitudinal steps 20913 b and 20913 c. Similarly, the intermediatelongitudinal step 20913 b is closer to the anvil jaw 20410 than thelongitudinal step 20913 c and, owing to its height, the longitudinalstep 20913 b applies a larger clamping pressure to the patient tissuecaptured between the staple cartridge 20900 and the anvil jaw 20410 thanthe longitudinal step 20913 c. Such an arrangement can hold the patienttissue tightly alongside the longitudinal slot 20914 such that thetissue cutting knife passing through the longitudinal slot 20914 doesnot push and/or disorient the patient tissue during the staple firingstroke. Such an arrangement also provides relief to the patient tissueat the lateral edges of the end effector 20400 so that the patienttissue does not rip or tear.

In addition to or in lieu of the above, the tissue supporting surface ofan anvil jaw can comprise longitudinal steps to create a tighter tissuegap along the tissue cut line and a wider tissue gap along the lateralouter edges of the end effector. Such an arrangement can also positionthe staple forming pockets of the anvil to create smaller as-deformedinner staples along the tissue cut line, larger intermediate as-deformedstaples adjacent the inner staples, and outer as-deformed staples whichare larger than the intermediate as-deformed staples, for example.

Further to the above, the anvil 20410 comprises a longitudinal slot20414 defined therein which, like the longitudinal slot 20914, isconfigured to receive a tissue cutting knife. The anvil 20410 furthercomprises concentration features configured to concentrate the tissueforces between the anvil jaw 20410 and the staple cartridge 20900. Forinstance, the anvil 20410 comprises longitudinal concentration features20413 a, 20413 b, and 20413 c defined on both sides of the longitudinalslot 20914. The longitudinal concentration features 20413 a are alignedwith the first longitudinal steps 20913 a of the staple cartridge 20900when the anvil jaw 20410 is in its closed position; however, theconcentration features 20413 a do not extend over the entire width ofthe first longitudinal steps 20913 a. As a result, the tissue gapbetween the anvil 20410 and the staple cartridge 20900 is narrowimmediately under the concentration features 20413 a which increases thecompression being applied to the tissue immediately under andsurrounding the concentration features 20413 a. Similarly, thelongitudinal concentration features 20413 b are aligned with the secondlongitudinal steps 20913 b of the staple cartridge 20900 when the anviljaw 20410 is in its closed position; however, the concentration features20413 b do not extend over the entire width of the second longitudinalsteps 20913 b. As a result, the tissue gap between the anvil 20410 andthe staple cartridge 20900 is narrow immediately under the concentrationfeatures 20413 b which increases the compression being applied to thetissue immediately under and surrounding the concentration features20413 b. Likewise, the longitudinal concentration features 20413 a arealigned with the third longitudinal steps 20913 c of the staplecartridge 20900 when the anvil jaw 20410 is in its closed position;however, the concentration features 20413 c do not extend over theentire width of the third longitudinal steps 20913 c. As a result, thetissue gap between the anvil 20410 and the staple cartridge 20900 isnarrow immediately under the concentration features 20413 c whichincreases the compression being applied to the tissue immediately underand surrounding the concentration features 20413 c.

Referring again to FIG. 47 , each concentration feature 20413 a has afirst lateral width, each concentration feature 20413 b has a secondlateral width which is wider than the first lateral width, and eachconcentration feature 20413 c has a third lateral width which is widerthan the second lateral width. As a result, the force concentrationunder the concentration features 20413 a is greater than the forceconcentration under the concentration features 20413 b. Similarly, as aresult, the force concentration under the concentration features 20413 bis greater than the force concentration under the concentration features20413 c. As a result of the above, the first staples deployed from thefirst staple cavities 20420 a will have a shorter post-fired height thanthe second staples deployed from the second staple cavities 20420 b.Similarly, as a result of the above, the second staples deployed fromthe second staple cavities 20420 b will have a shorter post-fired heightthan the third staples deployed from the third staple cavities 20420 c.

Further to the above, a tissue cutting knife is moved through the staplecartridge 20900 to fire the staples stored therein during a staplefiring stroke. In many instances, the tissue cutting knife is very sharpand/or the patient tissue is not very tough and/or dense. In suchinstances, the tissue cutting knife easily passes through the patienttissue without displacing the tissue distally. In other instances, thetissue cutting knife may not easily cut the tissue and may push some ofthe patient tissue captured within the end effector 20400 out of thedistal end of the end effector 20400, thereby resulting in less tissuebeing stapled during the staple firing stroke. Referring again to FIG.47 , the cartridge body 20910 comprises distal tissue stops positionedat the distal end of the staple cartridge 20900 which prevent, or atleast inhibit, the tissue from flowing distally out of the end effector20400. The distal tissue stops comprise bumps, or domes, positioned atthe distal ends of the longitudinal steps 20913 a, 20913 b, and 20913 c,but could comprise any suitable configuration. The cartridge body 20910comprises distal tissue stops 20919 a positioned at the distal ends ofthe longitudinal steps 20913 a, distal tissue stops 20919 b positionedat the distal ends of the longitudinal steps 20913 b, and distal tissuestops 20919 c positioned at the distal ends of the longitudinal steps20913 a.

In various embodiments, further to the above, a staple cartridge cancomprise a distal wall which can block the distal migration or flow ofthe tissue out of the end effector. In at least one embodiment, theperimeter of the staple cartridge is raised to control both longitudinaland lateral tissue flow. In various embodiments, the perimeter of thestaple cartridge, including the distal end, for example, comprises arough surface, or texture, which can prevent, or at least inhibit, theflow of the tissue out of the end effector. In at least one suchembodiment, the rough surface texture around the perimeter of thecartridge deck can be about 10 times as rough as the rest of the decksurface, for example.

In various embodiments, referring now to FIG. 58 , an end effector 29400of a stapling instrument comprises an anvil jaw 29410 and a cartridgejaw 29420. The anvil jaw 29410 comprises a proximal end 29412 and adistal end 29411 where the proximal end 29412 is rotatably mounted tothe cartridge jaw 29420 and is rotatable relative to the cartridge jaw29420 between an open, or unclamped, position and a closed, or clamped,position (FIG. 58 ). Referring to FIG. 59 , the anvil jaw 29410 furthercomprises a flat, or an at least substantially flat, tissue compressionsurface 29417 extending between the proximal end 29412 and the distalend 29411, a longitudinal slot 29414 extending from the proximal end29412 toward the distal end 29411 which is configured to receive atissue cutting knife, and longitudinal rows of staple forming pockets29313 defined on opposite sides of the longitudinal slot 29414. Theanvil jaw 29410 further comprises proximal tissue stops 29414 extendingdownwardly toward the cartridge jaw 29420, which are discussed furtherbelow.

Referring to FIG. 61 , the cartridge jaw 29420 comprises a bottom wall29922 and lateral sidewalls 29924 extending therefrom which define achannel configured to receive a staple cartridge therein. Referring toFIGS. 58 and 60 , the end effector 29400 further comprises a staplecartridge 29900 seated in the channel defined by the cartridge jaw29420. The staple cartridge 29900 comprises a cartridge body 29910including a proximal end 29912 and a distal end 29911, a deck 29913extending between the proximal end 29912 and the distal end 29911 whichis configured to support patient tissue, and a longitudinal slot 29914extending from the proximal end 29912 toward the distal end 29911 whichis configured to receive the tissue cutting knife. Referring again toFIG. 61 , the staple cartridge 29900 is configured to be closelyreceived between the lateral sidewalls 29924 of the cartridge jaw 29420.Moreover, the cartridge body 29910 comprises lateral support flanges29919 extending therefrom which are in contact with the top surfaces ofthe lateral sidewalls 29924 which support the staple cartridge 29900within the cartridge jaw 29420. Referring again to FIG. 60 , the staplecartridge 29900 further comprises longitudinal rows of staple cavities29920 defined in the cartridge body 29910 on opposite sides of thelongitudinal slot 29914 which contain staples removably stored therein.During a staple firing stroke, the staples are ejected from the staplecavities 29920 by the tissue cutting knife and deformed against thestaple forming pockets 29913 of the anvil jaw 29910.

Further to the above, referring to FIG. 60 , the cartridge jaw 29420further comprises proximal tissue stops 29429 extending upwardly towardthe anvil jaw 29410. Referring to FIG. 58 , the anvil tissue stops 29419and the cartridge tissue stops 29429 co-operate to prevent patienttissue from moving proximally into the end effector 29400 where thetissue may accidentally contact the tissue cutting knife in its proximalunactuated position. Moreover, the anvil tissue stops 29419 and thecartridge tissue stops 29429 co-operate to keep the patient tissue overthe staple cavities 29920 defined in the staple cartridge 29900 suchthat the proximal-most tissue captured within the end effector 29400 isstapled during the staple firing stroke. The reader should note that thestaple cavities 29220 extend proximally to and/or proximally past theproximal tissue stops 29429, even though this is not depicted in FIG. 60. Similarly, the reader should note that the staple forming pockets29413 defined in the anvil jaw 29410 extend proximally to and/orproximally past the proximal tissue stops 29419. The reader should alsonote, referring to FIG. 58 , that the camber of the tissue compressionsurface 29417 of the anvil jaw 29410 is angled downwardly toward thestaple cartridge 29900 to prevent, or at least inhibit, the tissuecaptured between the anvil jaw 29410 and the staple cartridge 29900 fromflowing out of the distal end of the end effector 29400.

Further to the above, referring to FIGS. 59 and 61 , the end effector29400 further comprises an implantable layer, or adjunct, 29430releasably attached to the anvil jaw 29410. The implantable layer 29430comprises a longitudinal rib 29434 extending therefrom which ispositioned in the longitudinal slot 29414 defined in the anvil jaw29410. The longitudinal rib 29434 is sized and configured such that rib29434 is compressed between the sidewalls of the longitudinal slot29414. Such an arrangement releasably retains the implantable layer29430 to the anvil jaw 29410. That said, the tissue cutting knifeprogressively transects the implantable layer 29430 through thelongitudinal rib 29434 as the tissue cutting knife is progressed throughthe staple firing stroke to release the rib 29434 from the longitudinalslot 29414. Notably, the implantable layer 29430 covers all of thetissue forming pockets 29413 of the anvil jaw 29410, but otherembodiments are envisioned in which less than all of the staple formingpockets 29413 are covered by the implantable layer 29430. In addition toor in lieu of the longitudinal rib 29434 to secure the implantable layer29430 to the anvil jaw 29410, the implantable layer 29430 comprisesdistal retention members 29435 extending from a distal end 29431 of theimplantable layer 29430 which are press-fit and releasably receivedwithin distal retention apertures 29415 defined in the anvil jaw 29410.Similarly, the implantable layer 29430 comprises proximal retentionmembers 29436 extending from a proximal end 29432 of the implantablelayer 29430 which are press-fit within proximal retention apertures29416 defined in the anvil jaw 29410. During the staple firing stroke,the staples ejected from the staple cartridge 29900 penetrate thepatient tissue and the implantable layer 29430 and then capture theimplantable layer 29430 against the patient tissue as the staples aredeformed against the staple forming pockets 29413. After the staplefiring stroke has been completed and the end effector 29400 is opened,the implantable layer 29430 releases from the anvil jaw 29410 andremains with the stapled patient tissue.

Further to the above, referring to FIGS. 60 and 61 , the end effector29400 further comprises an implantable layer, or adjunct, 29930releasably attached to the cartridge jaw 29420. The implantable layer29930 comprises a longitudinal rib 29934 extending therefrom which ispositioned in the longitudinal slot 29914 defined in the cartridge body29910. The longitudinal rib 29934 is sized and configured such that therib 29934 is compressed between the sidewalls of the longitudinal slot29914. Such an arrangement releasably retains the implantable layer29930 to the cartridge jaw 29420. That said, the tissue cutting knifeprogressively transects the implantable layer 29930 through thelongitudinal rib 29934 as the tissue cutting knife is progressed throughthe staple firing stroke to release the rib 29934 from the slot 29914.Notably, the implantable layer 29930 covers all of the staple cavities29920 of the staple cartridge 29900, but other embodiments areenvisioned in which less than all of the staple cavities 29920 arecovered by the implantable layer 29930. In addition to or in lieu of thelongitudinal rib 29934 to secure the implantable layer 29930 to thecartridge body 29910, the implantable layer 29930 comprises retentionmembers 29935 extending from a distal end 29931, a proximal end 29932,and an intermediate portion of the implantable layer 29930 which arepress-fit and releasably received within longitudinal retention slots29915 defined in the lateral sides of the cartridge jaw 29910. Duringthe staple firing stroke, the staples ejected from the staple cartridge29900 penetrate the implantable layer 29930 and the patient tissue andthen capture the implantable layer 29930 against the patient tissue asthe staples are deformed against the staple forming pockets 29413. Afterthe staple firing stroke has been completed and the end effector 29400is opened, the implantable layer 29930 releases from the cartridge body29910 and remains with the stapled patient tissue.

Further to the above, referring again to FIG. 60 , the longitudinalretention slots 29915 comprise open ends at the distal end 29911 of thecartridge body 29910. The open ends of the retention slots 29915 areconfigured to receive the retention members 29935 when the implantablelayer 29930 is slid, or assembled, longitudinally onto the cartridgebody 29910 from the distal end 29911 of the cartridge body 29910. Suchdistal openings also assist in the implantable layer 29930 detachingfrom the cartridge body 29910. More specifically, the end effector 29400is often pulled longitudinally away from the stapled tissue after theend effector 29400 has been opened and, in such instances, the retentionslots 29915, and their distal openings, are aligned with thiscommonly-used motion of the end effector 29400.

The implantable layers 29430 and 29930 provide several benefits. Invarious instances, the implantable layers 29430 and 29930 buttress thepatient tissue being stapled which prevents, or at least inhibits, thepatient tissue from tearing, especially when the patient tissue is thin,for example. Also, in various instances, the implantable layers 29430and 29930 are comprised of a compressible material and can compensatefor changes in tissue thickness within a line of implanted staples.Moreover, in various instances, the implantable layers 29430 and 29930can prevent, or at least inhibit, the implanted staples from pullingthrough the patient tissue. These benefits can be obtained, in varyingdegrees, if both the implantable layers 29430 and 29930 are implantedagainst the patient tissue or if only one of the implantable layers29430 and 29930 are implanted against the patient tissue. The entiredisclosure of U.S. Pat. No. 8,740,037, entitled COMPRESSIBLE FASTENERCARTRIDGE, filed on Sep. 30, 2010, is incorporated by reference herein.

Further to the above, the press-fit and/or friction fit between theretention members 29935 and the retention slots 29915 prevents, or atleast inhibits, the implantable layer 29930 from sliding relative to thecartridge body 29910 when the end effector 29400 is positioned relativeto the patient tissue and also when the tissue cutting knife is advancedthrough the patient tissue during the staple firing stroke. Among otherthings, the interaction between the retention members 29935 and theretention slots 29915 prevents the implantable layer 29930 from slidinglaterally and/or longitudinally relative to the cartridge body 29910.

Referring again to FIG. 58 , the distal tip 29411 of the anvil jaw 29410is cambered downwardly toward the distal nose 29911 of the staplecartridge 29900 when the anvil jaw 29410 is in its clamped position. Asa result, the tissue gap between the anvil jaw 29410 and the staplecartridge 29900 may be small at the distal end of the end effector29400. In such instances, the distal end of the end effector 29400 canbe used as a dissector to grasp and move tissue, for example.

In various embodiments, the distal tip 29411 of the anvil jaw 29410 ismovable relative to the main body of the anvil jaw 29410. In at leastone such embodiment, the main body defines a guide rail and the distaltip 29411 is slideable along the guide rail. When the anvil jaw 29410 isclosed and the distal tip 29411 contacts the tissue, the distal tip29411 can slide along the rail in reaction to the clamping force beingapplied to the tissue. In at least one embodiment, the rail extendslongitudinally and the distal tip 29411 slides distally along thelongitudinal rail to expand the tissue gap between the distal ends ofthe anvil jaw 29410 and the staple cartridge 29900. In at least oneembodiment, the rail extends vertically and the distal tip 29411 slidesalong the vertical rail to expand the tissue gap between the distal endsof the anvil jaw 29410 and the staple cartridge 29900. In either event,the anvil jaw 29410 further comprises a spring connecting the distal tip29411 to the main body of the anvil jaw 29410 which biases the distaltip 29411 back into its undisplaced position when the anvil jaw 29410 isre-opened. As a result of the above, the sliding distal tip 29411 canreduce the possibility of the tissue being pinched between the anvil jaw29410 and the staple cartridge 29900. Moreover, the displacement of thedistal tip 29411 can provide a visual indicator to the clinician thatthe tissue between the anvil jaw 29410 and the staple cartridge 29900has been sufficiently compressed.

In addition to or in lieu of the above, the distal nose 29911 of thestaple cartridge 29900 is movable relative to the main body of thecartridge body 29910. In at least one such embodiment, the cartridgebody 29910 defines a guide rail and the distal nose 29911 is slideablealong the guide rail. When the anvil jaw 29410 is closed, the cartridgenose 29911 can slide inwardly along the rail in reaction to the clampingforce being applied to the tissue. In at least one embodiment, the railextends longitudinally and the distal nose 29911 slides distally alongthe longitudinal rail to expand the tissue gap between the distal endsof the anvil jaw 29410 and the staple cartridge 29900. The entiredisclosures of U.S. Pat. No. 9,039,736, entitled SURGICAL STAPLINGDEVICE WITH DISSECTING TIP, which issued on May 26, 2015, U.S. Pat. No.8,136,711, entitled DISSECTION TIP AND INTRODUCER FOR SURGICALINSTRUMENT, which issued on Mar. 20, 2012, U.S. Pat. No. 8,714,429,entitled DISSECTING TIP FOR SURGICAL STAPLER, which issued on May 6,2014, and European Patent No. EP 2,913,010, entitled INTRODUCER ASSEMBLYFOR A SURGICAL FASTENER APPLYING APPARATUS are incorporated by referenceherein.

A staple cartridge 29900′ is illustrated in FIG. 61A and is similar tothe staple cartridge 29900 in many respects, most of which will not bediscussed herein for the sake of brevity. The staple cartridge 29900′comprises a cartridge body 29910′ and an implantable layer 29930′releasably attached to the cartridge body 29910′. The cartridge body29910′ comprises a deck 29913′ and recesses, or dwells, 29918′ definedtherein which surround at least some of the openings of the staplecavities 29920 defined in the deck 29913′. The implantable layer 29930′comprises projections, or swells, 29938′ extending therefrom which arepositioned in the recesses 29918′ which resist relative lateral andlongitudinal sliding motion between the implantable layer 29930′ and thecartridge body 29910′. The recesses 29918′ comprise crescent-shapedpockets, but could comprise any suitable shape, and the projections29938′ are shaped and configured to complement or match the recesses29918′. Such an arrangement can create an undulating or wavy top surfaceof the deck 29913′, for example.

A staple cartridge 29900″ is illustrated in FIG. 61B and is similar tothe staple cartridges 29900 and 29900′ in many respects, most of whichwill not be discussed herein for the sake of brevity. The staplecartridge 29900″ comprises a cartridge body 29910″ and an implantablelayer 29930″ releasably connected to the cartridge body 29910″. Thecartridge body 29910″ comprises a deck 29913″ and recesses 29918″defined therein which surround the openings of the staple cavities 29920defined in the deck 29913″. Each recess 29918″ comprises a roundedprofile and sloped walls. In at least one such embodiment, the recesses29918″ do not comprise vertical walls. The cartridge body 29910″ furthercomprises a dimple 29919″ extending upwardly from the bottom of eachrecess 29918″. Similar to the recesses 29918″, the dimples 29919″surround the openings of the staple cavities 29920 defined in the deck29913″ and comprise sloped walls. In at least one such embodiment, thedimples 29919″ do not comprise vertical walls.

The implantable layer 29930″ comprises recesses 29938″ defined thereinwhich define bumps that extend into the recesses 29918″ defined in thecartridge body 29910″. The implantable layer 29930″ further comprisesdimples 29939″ in the recesses 29938″ which are aligned, or at leastsubstantially aligned, with the staples 29970″ positioned in the staplecavities 29920. In at least one such embodiment, the tips of the staplelegs are embedded in the dimples 29939″ of the implantable layer 29930″when the staples 29970″ are stored in their unfired positions in thestaple cavities 29920. In other embodiments, the tips of the staple legsare positioned just below the dimples 29939″ when the staples 29970″ arestored in their unfired positions.

Further to the above, referring again to FIG. 61B, the implantable layer29930″ comprises a thickness 29937″ and is comprised of a malleablematerial, for example. Notably, the thickness 29937″ may or may not beconstant across the entire implantable layer 29930″. The height of thedimples 29919″ is less than the thickness 29937″ of the implantablelayer 29930″. Moreover, the recesses 29918″ defined in the cartridgebody 29910″ have a depth 29917″ which is larger than the height of thedimples 29919″. As a result, the dimples 29919″ do not extend above thedeck 29913″. That said, the layer 29930″ is in contact with the dimples29919″ which prevents, or at least inhibits, the layer 29930″ fromsliding laterally and/or longitudinally relative to the cartridge deck29910″.

Referring now to FIGS. 54 and 55 , an end effector 26400 comprises ananvil jaw 26410 and a cartridge jaw comprising a staple cartridge 26900positioned therein. The anvil jaw 26410 comprises a longitudinal slot26414 which is configured to receive a tissue cutting knife. The anviljaw 26410 further comprises a tissue compression surface 26417 andlongitudinal rows of staple forming pockets 26413 defined in the tissuecompression surface 26417. The staple cartridge 26900 comprises acartridge body 26910 including a proximal end 26912 and a distal end26911, a deck 26913 extending between the proximal end 26912 and thedistal end 26911 which is configured to support patient tissue, and alongitudinal slot 26914 extending from the proximal end 26912 toward thedistal end 26911 which is configured to receive the tissue cuttingknife. The staple cartridge 26900 further comprises longitudinal rows ofstaple cavities 26920 defined in the deck 26913 on opposite sides of thelongitudinal slot 26914 which contain staples removably stored therein.During a staple firing stroke, the staples are ejected from the staplecavities 26920 by the tissue cutting knife and deformed against thestaple forming pockets 26913 of the anvil jaw 26910.

Further to the above, the staple cartridge 26900 further comprises animplantable layer 26930 releasably attached to the cartridge body 26910.The cartridge body 26910 comprises longitudinal retention slots 26915defined therein which, similar to the above, comprise open distal endswhich permit the implantable layer 26930 to be slid longitudinally ontothe cartridge body 26910 when assembling the implantable layer 26930onto the cartridge body 26910 and/or slid longitudinally off of thecartridge body 26910 after implanting the layer 26930 against thepatient tissue. The implantable layer 26930 comprises lateral retentionfolds 26935 extending longitudinally along the lateral sides thereofwhich are positioned within and releasably secured within thelongitudinal retention slots 26915. When the end effector 26400 isclamped against patient tissue, in various instances, the tissue mayflow into the retention slots 26915 onto the retention folds 26935which, absent other considerations, may loosen the grip of the endeffector jaws on this portion of the patient tissue. Referring primarilyto FIG. 55A, the anvil jaw 26410 comprises longitudinal rails 26415defined thereon which are aligned with the retention slots 26915 and areconfigured to push the patient tissue into the retention slots 26915 andimprove the grip of the end effector jaws onto the patient tissue.

Referring again to FIG. 55A, the opposing sidewalls of the retentionsslots 26915 are vertical and the lateral retention folds 26935 comprisea corresponding configuration to that of the retention slots 26915.Similarly, the longitudinal rails 26415 comprise vertical sidewallswhich correspond to the vertical sidewalls of the retention slots 26915.An alternative embodiment is illustrated in FIG. 55B which comprises acartridge body 26910′ including a longitudinal retention slot 26915′, animplantable layer 26930′ including a lateral retention fold 26935′releasably secured within the retention slot 26915′, and an anvil jaw26410′ comprising a longitudinal rail 26415′ configured to grip thepatient tissue when the anvil jaw 26410′ is in a closed position.Notably, the opposing sidewalls of the retention slot 26915′ are notvertical; rather, the opposing sidewalls of the retention slot 26915′are angled inwardly. The lateral retention fold 26935′ comprises acorresponding configuration to that of the retention slot 26915′ and thelongitudinal rail 26415′ comprises a tapered configuration which canimprove the tissue grip of the anvil jaw 26410′.

An alternative embodiment is illustrated in FIGS. 56 and 56A whichcomprises a cartridge body 27910 including longitudinal retentionnotches 27915, an implantable layer 27930 including lateral retentionfolds 27935 releasably secured within the retention notches 27915, andan anvil jaw 27410 comprising longitudinal rails 27415 configured togrip the patient tissue when the anvil jaw 27410 is in a closedposition. Notably, the sidewalls of the retention notches 27915 arevertical. The lateral retention folds 27935 comprise a correspondingconfiguration to that of the retention slots 27915 and the longitudinalrails 27415 comprise vertical sidewalls which correspond to thesidewalls of the retention notches 27915. An alternative embodiment isillustrated in FIG. 56B which comprises a cartridge body 27910′including a longitudinal retention notch 27915′, an implantable layer27930′ including a lateral retention fold 27935′ releasably securedwithin the retention notch 27915′, and an anvil jaw 27410 comprising alongitudinal rail 27415 configured to grip the patient tissue when theanvil jaw 27410 is in a closed position. Notably, the sidewall of theretention notch 27915′ is not vertical; rather, the sidewall of theretention notch 27915′ is angled inwardly. The lateral retention fold27935′ comprises a corresponding configuration to that of the retentionnotch 27915′. Such an arrangement can improve the retention of theimplantable layer 27930′ to the cartridge body 27910′.

Referring to FIG. 57 , a staple cartridge 28900 comprises a cartridgebody 28910 and an implantable layer 28930 releasably attached thereto.The cartridge body 28910 comprises a longitudinal slot 28914 definedtherein and longitudinal rows of staple cavities 28920 on opposite sidesof the longitudinal slot 28914. The implantable layer 28930 comprises alongitudinal fold 28934 press-fit and/or friction-fit into thelongitudinal slot 28914 which releasably holds the implantable layer28930 to the cartridge body 28910.

Further to the above, the cartridge body 28910 further compriseslongitudinal channels 28915 defined in the deck of the cartridge body28910. More specifically, each side of the cartridge deck comprises alongitudinal channel 28915 which defines a lower portion of thecartridge deck aligned with the outer rows of staple cavities 28920.Each side of the cartridge deck further comprises an inner longitudinalrow of staple cavities 28920 and an intermediate row of staple cavities28920 defined in an upper portion of the cartridge deck. The implantablelayer 28930 comprises longitudinal folds 28935 press-fit and/orfriction-fit into the longitudinal channels 28915 which releasably holdthe implantable layer 28930 to the cartridge body 28910. In variousembodiments, the staple drivers configured to fire the staples stored inthe outer longitudinal rows 28920 may not lift the outer staples to thesame height as the inner and intermediate staples. In at least one suchembodiment, the as-deformed size of the outer staples is larger than theas-deformed size of the inner staples and the intermediate staples. Inat least one other embodiment, the outer staples are deformed to thesame as-formed height as the inner staples and intermediate staplesdespite having a lower recessed deck.

An anvil jaw 22410 of a stapling instrument is illustrated in FIG. 50and is similar to the other anvil jaws disclosed herein in manyrespects, many of which will not be discussed herein for the sake ofbrevity. The anvil jaw 22410 comprises a cap, or cover, 22411 and tissuesupport plates 22412 welded to the cap 22411. Each support plate 22412comprises a longitudinal lateral rib 22417 folded therein which ispositioned in a longitudinal recess, or gutter, 22415 defined in afolded lateral lip of the cap 22411. In various instances, thelongitudinal lateral ribs 22417 are press-fit into their respectivelongitudinal recesses 22415 and then welded into place. As a result ofthe above, the anvil jaw 22410 is stiff and resists bending during thestaple firing stroke. The support plates 22412 are positioned andarranged such that a longitudinal slot 22414 is defined between thesupport plates 22412 and such that a longitudinal cavity 22416 isdefined between the support plates 22412 and the cap 22411. Thelongitudinal slot 22414 and the longitudinal cavity 22416 are sized andconfigured to receive a tissue cutting knife therein. Each support plate22412 comprises a longitudinal row of first, or innermost, stapleforming pockets defined therein, a longitudinal row of second, orintermediate, staple forming pockets defined therein, and a longitudinalrow of third, or outermost, staple forming pockets defined therein.

An anvil jaw 23410 of a stapling instrument is illustrated in FIG. 51and is similar to the other anvil jaws disclosed herein in manyrespects, many of which will not be discussed herein for the sake ofbrevity. The anvil jaw 23410 comprises a cap, or cover, 23411 and tissuesupport plates 23412 welded to the cap 23411. Each support plate 23412comprises a longitudinal lateral flange 23417 extending therefrom whichabuts the cap 23411. In at least one instance, openings, or apertures,are defined in the cap 23411 which allow the lateral flanges 23417 to bedirectly welded to the cap 23411 so that the support plates 23412 areheld securely in position relative to the cap 23411. As a result of theabove, the anvil jaw 23410 is stiff and resists bending during thestaple firing stroke. The support plates 23412 are positioned andarranged such that a longitudinal slot 23414 is defined between thesupport plates 23412 and such that a longitudinal cavity 23416 isdefined between the support plates 23412 and the cap 23411. Thelongitudinal slot 23414 and the longitudinal cavity 23416 are sized andconfigured to receive a tissue cutting knife therein. Each support plate23412 comprises a longitudinal row of first, or innermost, stapleforming pockets defined therein, a longitudinal row of second, orintermediate, staple forming pockets defined therein, and a longitudinalrow of third, or outermost, staple forming pockets defined therein.

An anvil jaw 24410 of a stapling instrument is illustrated in FIGS. 52and 52A and is similar to the other anvil jaws disclosed herein in manyrespects, many of which will not be discussed herein for the sake ofbrevity. The anvil jaw 24410 comprises a cap, or cover, 24411 and tissuesupport plates 24412 welded to the cap 24411. Each support plate 24412comprises a longitudinal lateral flange 24417 extending therefrom whichis received in a folded lateral slot, or gutter, 24415 defined in thecap 24411. In at least one instance, openings, or apertures, are definedin the cap 24411 which allow the lateral flanges 24417 to be directlywelded to the cap 24411 via welds 24418 so that the support plates 24412are held securely in position relative to the cap 24411. As a result ofthe above, the anvil jaw 24410 is stiff and resists bending during thestaple firing stroke. The support plates 24412 are positioned andarranged such that a longitudinal slot 24414 is defined between thesupport plates 24412 and such that a longitudinal cavity 24416 isdefined between the support plates 24412 and the cap 24411. Thelongitudinal slot 24414 and the longitudinal cavity 24416 are sized andconfigured to receive a tissue cutting knife therein. Each support plate24412 comprises a longitudinal row of first, or innermost, stapleforming pockets defined therein, a longitudinal row of second, orintermediate, staple forming pockets defined therein, and a longitudinalrow of third, or outermost, staple forming pockets defined therein.

An anvil jaw 25410 of a stapling instrument is illustrated in FIG. 53and is similar to the other anvil jaws disclosed herein in manyrespects, many of which will not be discussed herein for the sake ofbrevity. The anvil jaw 25410 comprises a cap, or cover, 25411 and tissuesupport plates 25412 welded to the cap 25411 along the folded edges25415 of the cap 25411. In at least one instance, openings, orapertures, are defined in the cap 25411 which allow the support plates25412 to be directly welded to the cap 25411 so that the support plates25412 are held securely in position relative to the cap 25411. As aresult of the above, the anvil jaw 25410 is stiff and resists bendingduring the staple firing stroke. The support plates 25412 are positionedand arranged such that a longitudinal slot 25414 is defined between thesupport plates 25412 and such that a longitudinal cavity 25416 isdefined between the support plates 25412 and the cap 25411. Thelongitudinal slot 25414 and the longitudinal cavity 25416 are sized andconfigured to receive a tissue cutting knife therein. Each support plate25412 comprises a longitudinal row of first, or innermost, stapleforming pockets defined therein, a longitudinal row of second, orintermediate, staple forming pockets defined therein, and a longitudinalrow of third, or outermost, staple forming pockets defined therein.

As mentioned above, referring again to FIG. 1 , the loading unit 1300comprises an articulation joint 1500. Referring now to FIG. 62 , theloading unit 1300 comprises a proximal shaft portion 1520 and a distalshaft portion 1530 connected by two links 1550 that pin the distal shaftportion 1530 to the proximal shaft portion 1520 but permit the distalshaft portion 1530 to rotate, or articulate, relative to the proximalshaft portion 1520, as illustrated in FIG. 64 . The distal end of eachlink 1550 is pinned to the distal shaft portion 1530 by a pin 1540 and,similarly, the proximal end of each link 1550 is pinned to the proximalshaft portion 1520 by another pin 1540. The loading unit 1300 furthercomprises a first articulation actuator 1570 connected to a first sideof the distal shaft portion 1530 and a second articulation actuator 1580connected to a second side of the distal shaft portion 1530. The loadingunit 1300 further comprises an articulation lock 1560 configured to beengaged with an annular array of lock teeth 1535 defined on the distalshaft portion 1530 when the articulation lock 1560 is in a lockedposition and disengaged from the distal shaft portion 1530 when thearticulation lock 1560 is in an unlocked position (FIGS. 63 and 64 ).When the articulation lock 1560 is in its unlocked position (FIGS. 63and 64 ), one or both of the articulation actuators 1570 can be pushedand/or pulled to articulate the end effector 1400 of the loading unitabout the articulation joint 1500. In various embodiments, thearticulation actuators 1560 and 1570 are coupled to an articulationinput actuator 1510 (FIG. 3 ) which is rotatable in a first direction topush the first articulation actuator 1570 distally and pull the secondarticulation actuator 1580 proximally to rotate the end effector 1400 ina first direction and, similarly, rotatable in a second direction topull the first articulation actuator 1570 proximally and push the secondarticulation actuator 1580 distally to rotate the end effector 1400 in asecond direction. When the clinician is satisfied with the orientationof the end effector 1400, the clinician can move the articulation lock1560 into its locked position to prevent the end effector 1400 fromrotating. The entire disclosures of U.S. Pat. No. 9,186,142, entitledSURGICAL INSTRUMENT END EFFECTOR ARTICULATION DRIVE WITH PINION ANDOPPOSING RACKS, and U.S. Pat. No. 8,353,437, entitled SURGICAL STAPLINGINSTRUMENT WITH A GEARED RETURN MECHANISM, which issued on Jan. 15, 2013are incorporated herein by reference.

A schematic representation of a surgical stapling instrument 30000 isillustrated in FIG. 65 . The stapling instrument 30000 comprises threeindependent motor-driven actuation systems—a first actuation system30200 for articulating an end effector of the stapling instrument 30000,a second actuation system 30300 for closing the end effector, and athird actuation system 30400 for performing a staple firing stroke. Thestapling instrument 30000 further comprises a three-position switch30120 for controlling the actuation systems 30200, 30300, and 30400.When the switch 30120 is in a first position, power from a power source,such as a battery, for example, is available to operate the first, orarticulation, actuation system 30200. The articulation actuation system30200 comprises an electric motor 30230 that is controlled by adirectional switch 30240 and a relay switch 30260 with a set-resetfunction. When the switch 30120 is in a second position, power from thepower source is available to operate the second, or closure, actuationsystem 30300. The closure actuation system 30300 comprises an electricmotor 30330 that is controlled by an end-of-travel sensor 30340, abeginning-of-travel sensor 30350, and a momentary switch 30360. Theclosure actuation system 30300 further comprises indicator arrays 30370and 30380 which comprise light emitting diodes (LEDs) that indicate thestatus of the closure actuation system. When the switch 30120 is in athird position, power from the power source is available to operate thethird, or staple firing, actuation system 30400. The staple firingactuation system 30400 comprises an electric motor 30430 that iscontrolled by an end-of-travel sensor 30440, a beginning-of-travelsensor 30450, and a momentary switch 30460. The staple firing actuationsystem 30400 further comprises indicator arrays 30470 and 30480 whichcomprise light emitting diodes (LEDs) that indicate the status of thestaple firing actuation system.

Further to the above, a surgical stapling instrument 35000 comprising anindependent articulation system is illustrated in FIG. 66 . The staplinginstrument 35000 is similar to the stapling instruments 1000, 2000,30000 and other stapling instruments disclosed herein. The staplinginstrument 35000 comprises an end effector 35400 which is rotatableabout an articulation joint 35500 by a motor-driven articulation drive.The articulation drive comprises an electric motor 35590 comprising arotatable output 35595. The rotatable output 35595 comprises a helicalor worm gear, for example, but can comprise any suitable configuration.The rotatable output 35595 is nested within a threaded socket 35585 of aproximal articulation drive rod 35580 and, when the rotatable output35595 is rotated in a first direction, the proximal articulation driverod 35580 is advanced distally to articulate the end effector 35400 in afirst direction. Similarly, the proximal articulation drive rod 35580 isretracted proximally to articulate the end effector 35400 in a seconddirection when the rotatable output 35595 is rotated in a second, oropposite direction. As discussed in greater detail below, the motion ofthe proximal articulation drive rod 35580 is transmitted to the endeffector 35400 by a transfer gear 35570 and a distal articulation rod35570.

Further to the above, the proximal articulation drive rod 35580comprises a rack of teeth operably engaged with a first gear perimeter35572 of the transfer gear 35570 such that the longitudinal motion ofthe proximal articulation drive rod 35580 rotates the transfer gear35570. The transfer gear 35570 is rotatably mounted to a shaft frame ofthe stapling instrument 35000 about a pin 35576 and further comprises asecond gear perimeter 35574 operably engaged with the distalarticulation drive rod 35560 such that the rotation of the transfer gear35570 translates the distal articulation drive rod 35560. The distalarticulation drive rod 35560 comprises an elongate opening 35562 definedtherein including a sidewall which is configured to transmit thetranslation of the distal articulation drive rod 35560 to a frame 35420of the end effector 35400 through a drive pin 35422 that extends fromthe frame 35420 and extends into the elongate opening 35562. Notably,the distal articulation drive rod 35560 extends across the articulationjoint 35500 and, as a result, the translation of the distal articulationdrive rod 35560 rotates the end effector 35400 about the articulationjoint 35500.

As discussed above, the rotatable output 35595 of the motor 35590 isnested within the threaded socket 35585 of the proximal articulationdrive rod 35580 to transfer the rotational motion of the output 35595 tothe proximal articulation drive rod 35580. Notably, though, the threadedsocket 35585 does not entirely enclose the rotatable output 35595.Instead, the threaded socket 35585 only engages half, or about half, ofthe rotatable output 35595. As a result, it is possible for the threadedsocket 35585 and the rotatable output 35595 to disengage from oneanother when the load transmitted therebetween exceeds a threshold. Suchinstances can occur when the motion of the end effector 35400 isblocked, for example, and the force needed to drive the end effector35400 increases above the amount of force ordinarily needed toarticulate the end effector 35400, which is usually low. When thethreaded socket 35585 disconnects from the rotatable output 35595, thearticulation drive is no longer driven by the motor 35590. Thearticulation drive further comprises an elastic sleeve 35550 surroundingor encompassing the interface between the threaded socket 35585 and therotatable output 35595 that is configured to re-seat or re-engage thethreaded socket 35585 and the rotatable output 35595 when the loadtransmitted through the firing drive falls back below the threshold. Theelastic sleeve 35550 is comprised of rubber, for example, but could becomprised of any suitable material. When the threaded socket 35585decouples from the rotatable output 35595, the elastic sleeve 35550resiliently expands to accommodate the decoupling of the threaded socket35585 and acts to resiliently contract to re-engage the threaded socket35585 with the rotatable output 35595.

In various embodiments, further to the above, an articulation drivesystem can comprise one or more resilient features engaged with, orengageable with, the end effector 35400 which resist, but permit, therotation of the end effector 35400. Such resilient features can prevent,or at least inhibit, small unintentional movements of the end effector35400.

In various embodiments, further to the above, a surgical staplinginstrument can comprise one motor that is operable to drive more thanone drive system of the stapling instrument. In at least one suchembodiment, the stapling instrument is switchable between a firstconfiguration in which the motor is operable to drive the articulationdrive system and a second configuration in which the motor is operableto drive the staple firing drive system, for example. The entiredisclosure of U.S. Pat. No. 9,101,358, entitled ARTICULATABLE SURGICALINSTRUMENT COMPRISING A FIRING DRIVE, which issued on Aug. 11, 2015, isincorporated by reference herein. The entire disclosure of U.S. Pat. No.5,865,361, entitled SURGICAL STAPLING APPARATUS, which issued on Feb. 2,2019, is incorporated by reference herein.

As discussed above, referring again to FIG. 1 , the shaft 1200 of thestapling instrument 1000 is rotatable relative to the handle 1100 abouta longitudinal axis. More specifically, the stapling instrument 1000comprises a rotation joint positioned within the nozzle of the shaftthat permits the shaft 1200 to rotate relative to the handle 1100. Invarious instances, a considerable amount of friction can be presentwithin the rotation joint which prevents, or at least inhibits, theshaft 1200 from unintentionally rotating relative to the handle 1100. Inat least one embodiment, the shaft 1200 comprises a spring-loaded lockelement biased into engagement with the handle 1100 which holds theshaft 1200 in position relative to the handle 1100. The handle 1100comprises a circumferential ring of lock recesses extending around theouter housing which are each configured to receive the spring-loadedlock element therein. The interaction between the spring-loaded lockelement and a lock recess resists the rotation of the shaft 1200relative to the handle 1100. This resistance can be overcome by theclinician to rotate the shaft 1200 without having to release, or holdopen, the spring-loaded lock element. That said, the clinician can holdopen the spring-loaded lock element to freely rotate the shaft 1200relative to the handle 1100. In various alternative embodiments, thespring-loaded lock element is mounted to the handle 1100 and thecircumferential ring of lock recesses is defined on the outer housing ofthe shaft 1200.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

The entire disclosures of:

-   -   U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC        DEVICE, which issued on Apr. 4, 1995;    -   U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT        HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which        issued on Feb. 21, 2006;    -   U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING        AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which        issued on Sep. 9, 2008;    -   U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL        INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS,        which issued on Dec. 16, 2008;    -   U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN        ARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;    -   U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS,        which issued on Jul. 13, 2010;    -   U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE        IMPLANTABLE FASTENER CARTRIDGE, which issued on Mar. 12, 2013;    -   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL        INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.        7,845,537;    -   U.S. patent application Ser. No. 12/031,573, entitled SURGICAL        CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed        Feb. 14, 2008;    -   U.S. patent application Ser. No. 12/031,873, entitled END        EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed        Feb. 15, 2008, now U.S. Pat. No. 7,980,443;    -   U.S. patent application Ser. No. 12/235,782, entitled        MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now U.S. Pat. No.        8,210,411;    -   U.S. patent application Ser. No. 12/235,972, entitled MOTORIZED        SURGICAL INSTRUMENT, now U.S. Pat. No. 9,050,083;    -   U.S. patent application Ser. No. 12/249,117, entitled POWERED        SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY        RETRACTABLE FIRING SYSTEM, now U.S. Pat. No. 8,608,045;    -   U.S. patent application Ser. No. 12/647,100, entitled        MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR        DIRECTIONAL CONTROL ASSEMBLY, filed Dec. 24, 2009, now U.S. Pat.        No. 8,220,688;    -   U.S. patent application Ser. No. 12/893,461, entitled STAPLE        CARTRIDGE, filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;    -   U.S. patent application Ser. No. 13/036,647, entitled SURGICAL        STAPLING INSTRUMENT, filed Feb. 28, 2011, now U.S. Pat. No.        8,561,870;    -   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL        STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT        ARRANGEMENTS, now U.S. Pat. No. 9,072,535;    -   U.S. patent application Ser. No. 13/524,049, entitled        ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE,        filed on Jun. 15, 2012, now U.S. Pat. No. 9,101,358;    -   U.S. patent application Ser. No. 13/800,025, entitled STAPLE        CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13,        2013, now U.S. Pat. No. 9,345,481;    -   U.S. patent application Ser. No. 13/800,067, entitled STAPLE        CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13,        2013, now U.S. Patent Application Publication No. 2014/0263552;    -   U.S. Patent Application Publication No. 2007/0175955, entitled        SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER        LOCKING MECHANISM, filed Jan. 31, 2006; and    -   U.S. Patent Application Publication No. 2010/0264194, entitled        SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR,        filed Apr. 22, 2010, now U.S. Pat. No. 8,308,040, are hereby        incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one or moreother embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

What is claimed is:
 1. A surgical stapling instrument, comprising: anend effector, comprising: a cartridge jaw; an anvil rotatable relativeto said cartridge jaw between an open position and a clamped positionabout a jaw pivot, wherein said anvil comprises: a proximal portion; adistal end; and a longitudinal shoulder comprising a ramp adjacent saidproximal portion; an end effector frame; a closure actuator rotatablymounted to said end effector frame about a pivot pin, wherein saidclosure actuator comprises a closure arm extending distally relative tosaid pivot pin and a compression arm extending proximally relative tosaid pivot pin and proximally relative to said jaw pivot; and a springpositioned intermediate said proximal portion of said anvil and saidcompression arm, wherein said spring is proximal to said jaw pivot; anda firing head movable distally during a closure stroke to move saidanvil into said clamped position and distally during a staple firingstroke to eject staples from a staple cartridge positioned in saidcartridge jaw, wherein said firing head comprises: a first camconfigured to engage said cartridge jaw during said staple firingstroke; a second cam, wherein said second cam is not engaged with saidlongitudinal shoulder of said anvil during said closure stroke, whereinsaid second cam is configured to engage said closure arm of said closureactuator during said closure stroke to rotate said compression armtoward said proximal portion of said anvil and push said anvil into saidclamped position via said spring, wherein said second cam is engagedwith said longitudinal shoulder during said staple firing stroke, andwherein said first cam and said second cam co-operatively hold saidanvil in position relative to said cartridge jaw during said staplefiring stroke; and a tissue cutting knife.
 2. The surgical staplinginstrument of claim 1, further comprising said staple cartridge, andwherein said staple cartridge is replaceable.
 3. The surgical staplinginstrument of claim 1, further comprising an electric motor configuredto drive said firing head through said closure stroke and said staplefiring stroke.
 4. The surgical stapling instrument of claim 3, furthercomprising a drive screw operably coupled with an output of saidelectric motor and said firing head.
 5. The surgical stapling instrumentof claim 4, further comprising a shaft and an articulation regionrotatably connecting said end effector to said shaft, wherein said drivescrew extends through said articulation region.
 6. The surgical staplinginstrument of claim 3, further comprising a firing bar operably coupledwith an output of said electric motor and said firing head.
 7. Thesurgical stapling instrument of claim 3, further comprising a housing isconfigured to be attached to a robotic surgical system.
 8. The surgicalstapling instrument of claim 3, further comprising a housing, whereinsaid housing comprises a handle.
 9. The surgical stapling instrument ofclaim 1, further comprising: a latch rotatably mounted to said cartridgejaw; and a spring configured to bias said latch from a disengagedposition to an engaged position, wherein said latch is not engaged withsaid closure actuator when said latch is in said disengaged position,wherein said latch is engaged with said closure actuator when said latchis in said engaged position to hold said anvil in said clamped position,wherein said firing head holds said latch in said disengaged positionprior to said closure stroke, wherein said firing head releases saidlatch to move into said engaged position during said closure stroke, andwherein said firing head is movable from a proximal unfired position toa distal fired position during said staple firing stroke.
 10. Thesurgical stapling instrument of claim 1, wherein said cartridge jawcomprises a longitudinal cavity, wherein said first cam is positionedwithin said longitudinal cavity and is configured to slide within saidlongitudinal cavity during said staple firing stroke, wherein saidlongitudinal cavity comprises a proximal end and a distal end, whereinsaid longitudinal cavity comprises a proximal gap height at saidproximal end and a distal gap height at said distal end, and whereinsaid proximal gap height is larger than said distal gap height.
 11. Thesurgical stapling instrument of claim 1, wherein said cartridge jawcomprises a bottom wall, a first sidewall extending upwardly from saidbottom wall, and a second sidewall extending upwardly from said bottomwall, wherein said staple cartridge is positioned between said firstsidewall and said second sidewall, wherein said bottom wall defines alongitudinal cavity, wherein said first cam is positioned within saidlongitudinal cavity and is configured to slide within said longitudinalcavity during said staple firing stroke, wherein said longitudinalcavity comprises a proximal end and a distal end, wherein said bottomwall comprises a proximal thickness at said proximal end and a distalthickness at said distal end, and wherein said distal thickness isthicker than said proximal thickness.
 12. A surgical staplinginstrument, comprising: an end effector, comprising: a first jaw; asecond jaw rotatable relative to said first jaw between an open positionand a clamped position about a jaw pivot, wherein said second jawcomprises: a proximal portion; a distal end; and a longitudinal shouldercomprising a ramp adjacent said proximal portion; and a closure actuatorrotatably mounted to said proximal portion about a pivot pin, whereinsaid closure actuator comprises a closure arm extending distallyrelative to said pivot pin and a compression arm extending proximallyrelative to said pivot pin and said jaw pivot; and a firing head movabledistally during a closure stroke to move said second jaw into saidclamped position and distally during a staple firing stroke to ejectstaples from a staple cartridge positioned in said end effector, whereinsaid firing head comprises: a first cam configured to engage said firstjaw during said staple firing stroke; and a second cam, wherein saidsecond cam is not engaged with said longitudinal shoulder of said secondjaw at the outset of said closure stroke, wherein said second cam isconfigured to engage said closure arm of said closure actuator duringsaid closure stroke to rotate said compression arm toward said proximalportion of said second jaw and push said second jaw into said clampedposition, wherein said second cam is engaged with said longitudinalshoulder during said staple firing stroke, and wherein said first camand said second cam co-operatively hold said second jaw in positionrelative to said first jaw during said staple firing stroke.
 13. Thesurgical stapling instrument of claim 12, wherein said firing headfurther comprises a tissue cutting edge.
 14. The surgical staplinginstrument of claim 12, further comprising said staple cartridge, andwherein said staple cartridge is replaceable.
 15. The surgical staplinginstrument of claim 12, further comprising: a latch rotatably mounted tosaid first jaw; and a spring configured to bias said latch from adisengaged position to an engaged position, wherein said latch is notengaged with said closure actuator when said latch is in said disengagedposition, wherein said latch is engaged with said closure actuator whensaid latch is in said engaged position to hold said second jaw in saidclamped position, wherein said firing head holds said latch in saiddisengaged position prior to said closure stroke, wherein said firinghead releases said latch to move into said engaged position during saidclosure stroke, and wherein said firing head is movable from a proximalunfired position to a distal fired position during said staple firingstroke.
 16. The surgical stapling instrument of claim 15, wherein saidfirst jaw comprises a longitudinal cavity, wherein said first cam ispositioned within said longitudinal cavity and is configured to slidewithin said longitudinal cavity during said staple firing stroke,wherein said longitudinal cavity comprises a proximal end and a distalend, wherein said longitudinal cavity comprises a proximal gap height atsaid proximal end and a distal gap height at said distal end, andwherein said proximal gap height is larger than said distal gap height.17. The surgical stapling instrument of claim 12, wherein said first jawcomprises a bottom wall, a first sidewall extending upwardly from saidbottom wall, and a second sidewall extending upwardly from said bottomwall, wherein said staple cartridge is positioned between said firstsidewall and said second sidewall, wherein said bottom wall defines alongitudinal cavity, wherein said first cam is positioned within saidlongitudinal cavity and is configured to slide within said longitudinalcavity during said staple firing stroke, wherein said longitudinalcavity comprises a proximal end and a distal end, wherein said bottomwall comprises a proximal thickness at said proximal end and a distalthickness at said distal end, and wherein said distal thickness isthicker than said proximal thickness.
 18. A surgical staplinginstrument, comprising: an end effector, comprising: a first jaw,comprising: a bottom wall; a first sidewall extending upwardly from saidbottom wall; a second sidewall extending upwardly from said bottom wall;and a longitudinal cavity defined in said bottom wall; and a second jawrotatable relative to said first jaw between an open position and aclamped position about a jaw pivot, wherein said second jaw comprises: aproximal portion; a distal end; and a longitudinal shoulder comprising aramp adjacent said proximal portion; and a firing head movable distallyduring a closure stroke to move said second jaw into said clampedposition and a staple firing stroke to eject staples from a staplecartridge seated in said end effector, wherein said firing headcomprises: a first cam configured to engage said first jaw during saidstaple firing stroke, wherein said first cam is positioned within saidlongitudinal cavity and is configured to slide within said longitudinalcavity during said staple firing stroke, wherein said longitudinalcavity comprises a proximal cavity end and a distal cavity end, whereinsaid bottom wall comprises a proximal thickness at said proximal cavityend and a distal thickness at said distal cavity end, and wherein saiddistal thickness is thicker than said proximal thickness; and a secondcam configured to engage said second jaw during said staple firingstroke.
 19. The surgical stapling instrument of claim 18, wherein saidfirst jaw comprises a proximal end and a distal end, and where saiddistal cavity end is adjacent said distal end of said first jaw.
 20. Thesurgical stapling instrument of claim 19, wherein said first cam isconfigured to engage said bottom wall to gradually increase a clampingforce said second jaw applies to tissue captured between said first jawand said second jaw during said staple firing stroke.
 21. A surgicalinstrument, comprising: an end effector, comprising: a first jaw; asecond jaw rotatable relative to said first jaw between an open positionand a closed position; and a closure actuator rotatable about a pivotpin, wherein said closure actuator comprises a first arm and a secondarm; and a firing beam movable through a stroke, wherein said second armis configured to rotate said second jaw toward said closed positionbased on said firing beam engaging said first arm during said stroke.22. The surgical instrument of claim 21, wherein the second arm isconfigured to engage said second jaw to rotate said second jaw towardsaid closed position.
 23. The surgical instrument of claim 21, furthercomprising a spring coupled to said second jaw and second arm, andwherein said second arm is configured to rotate said second jaw towardsaid closed position via said spring.
 24. The surgical instrument ofclaim 21, wherein said firing beam further comprises a cam, and whereinsaid second arm is configured to rotate said second jaw toward saidclosed position based on said cam engaging said first arm during saidstroke.
 25. The surgical instrument of claim 21, further comprising: alatch, moveable between: a disengaged position in which said latch isnot engaged with said closure actuator; and an engaged position in whichsaid latch is engaged with said closure actuator to hold said second jawin said closed position; and a spring configured to bias said latchtoward said engaged position.